A powerful group of conservative interest groups and activists penned a letter last week to Republican congressional leaders asking them to rein in a program that provides discounted outpatient drugs to rural Americans, alleging that it is being abused by hospitals for financial gain. Many of the letter’s signatories, however, are funded by the pharmaceutical industry, which stands to gain from reforms to the program.

“The 340B program is supposed to help hospitals provide care to indigent populations at low or no cost, but it is now routinely used fraudulently,” the letter reads. “Hospitals serving low income areas receive the medicines at low or no cost, but then distribute them throughout a vast hospital network, specifically targeting affluent areas, and increasing the price for everyone.”