The 340B drug discount program was intended to help low-income and uninsured patients afford medicine, not create lucrative revenue streams for hospital systems in wealthy communities. However, without oversight, that is what it has become. Congress should return the program to its intended purpose by requiring hospitals to show that the program reaches the vulnerable patients it was intended for.

The 340B program allows qualifying hospitals and other providers to purchase outpatient drugs at substantial discounts. They can then bill insurers, including Medicare, at normal reimbursement rates and retain the difference. Congress intended those savings to help safety-net providers stretch their resources and expand services for vulnerable patients. In practice, federal law does not require hospitals to prove those savings are passed on to patients or even disclose how the resulting revenue is spent.