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The Alliance for Integrity and Reform of 340B (AIR340B) announced the addition of four new members to the coalition: Citizens Against Government Waste (GAGW), Genentech, Medical Oncology Association of Southern California Inc. (MOASC), and the National Medical Association (NMA). These organizations join the diverse group of health care stakeholders that have come together to advance reforms that strengthen and sustain 340B.

A decade after the nation’s top hospitals used all their advertising and lobbying clout to keep their tax-exempt status, pointing to their vast givebacks to their communities, they have seen their revenue soar while cutting back on the very givebacks they were touting, according to a POLITICO analysis.

Even as health reform dominates much of the media landscape and the policy arena in Washington, there are many health policies and programs that have a large impact on the U.S. health system that are not getting the attention they deserve.

At Grady Memorial Hospital, where Atlanta’s poor and uninsured are welcomed, the pharmacy charges most patients $5 or less for outpatient medications that treat everything from diabetes to cancer.

To say the American healthcare system is complex is certainly an understatement. When even one healthcare program is not working, it affects us all. Seniors and lawmakers understand the importance of Medicare and work tirelessly to defend it, but we must also work to ensure that waste, fraud, and abuse have no place in the broader healthcare market. The 340B program is a prime example of a program that is being abused to the detriment of America’s seniors. And while the intentions of the program are good, the need for substantial reform is clear.

A Here we are in March 2017 and no one is sure where things stand with the 340B Drug Discount Program. HRSA and its oversight of the 340B program are subject to the recent Executive Orders restricting issuance of federal regulations and the promised repeal of the Affordable Care Act (ACA) has the potential to impact 340B operations. In fact, the only thing that appears certain for the 340B program is that nothing is certain. So let’s review several recent 340B developments, and potential developments to come.

Defenders of the 340B Drug Discount Program say it is vital to safety net hospitals and the patients they serve. On that, we agree wholeheartedly. The program was originally intended by Congress to provide assistance to those treating uninsured or underinsured patients so that this vulnerable population had access to medical treatment. However, inadequate oversight has distorted the noble intent of 340B, transforming it into a perverse profit generator for many of America’s tax-exempt hospitals, few of which provide any meaningful level of charity care.

President Donald Trump took an important step in the right direction when he recently met with pharmaceutical executives and expressed grave concern about high drug prices. Escalating prices, especially for life-saving cancer therapies, are a serious problem for patients that must be addressed.