Last week, U.S. Health and Human Services (HHS) Secretary Alex Azar testified before Congress on the 340B program, an almost 30-year-old initiative that provides prescription drugs to healthcare providers at a steep discount with the intention of providing low-income and patients access to critical drugs.

As we’ve written about previously, the 340B program is badly in need of reform, as it’s currently eating up taxpayer funds without fulfilling its purpose.

The program was created with broad bipartisan support and today 6,100 340B entities – namely, hospitals –have contracts with more than 52,000 pharmacies, at an almost $16 billion price tag – a 30 percent increase since 2015.

But questions about 340B have begun to emerge, as hospitals and other providers appear to be receiving discounts but patients are not.

A June GAO report shows that the program needs a serious overhaul, as hospitals and other providers are not required to report where revenue from 340B is spent. Instead, hospitals can pocket the savings without reducing costs for patients or otherwise improving care for low income patients.

It’s no wonder that hospitals oppose any changes to the program. They’re benefiting from the status quo.

Furthermore, the GAO report shows that there is no oversight of the program to stop duplicate payments from 340B to other, government programs that already discount prescriptions. These duplicate discounts are expressly forbidden by the program, but there is no mechanism to ensure that they are not happening. According to the GAO:

HRSA only assesses the potential for duplicate discounts in Medicaid fee-for-service and not Medicaid managed care. As a result, it cannot ensure compliance with this requirement for the majority of Medicaid prescriptions, which occur under managed care.

This means that other vital programs to ensure that low-income patients can afford or receive their prescriptions could be wasting money or that our government is paying hospitals and other facilities unnecessarily. This is money that could either be saved or given to critical-access programs and organization such as Ryan White AIDS clinics.

To be clear: the goal of the 340B program is to ensure that the most vulnerable Americans receive the care they need. But, as so often happens in Washington, the program has turned into a massive taxpayer subsidy of hospitals with no accountability.

It’s clear that we need to reform the 340B program to cut down on noncompliance, duplicate payments and outright abuse. What’s not clear is that our representatives in Washington have the stomach to tackle the problem in the near future.

We need them to. This is a problem that costs our government billions in taxpayer dollars. It is the definition of government waste and, in an era of exploding budgets and rampant spending, our elected officials must take action.