The Trump administration is considering a pilot program that could bring much-needed transparency to the 340B drug discount program, created by Congress to help hospitals and clinics serving low-income patients provide medications at discounted rates.

Under the 340B program, drug manufacturers provide medicines at steep discounts, which providers are supposed to pass on to vulnerable patients. Instead, large hospitals repeatedly take the manufacturer discount, bill patients and insurers at full price, and pocket the difference. And because the program lacks meaningful reporting requirements, hospitals generally do not have to demonstrate how those savings are spent or whether patients are directly benefiting.