Maine’s hospitals, pharmacists and health care providers are sparring with the pharmaceutical industry over a bill pending in the Maine Legislature that would regulate a federal discount drug program.

The bipartisan bill, LD 1018, would forbid drug manufacturers and pharmacy benefit managers — third-party middlemen — from placing constraints on the federal 340B drug discount program.

A public hearing over the contentious bill is slated for 1o a.m. Wednesday before the health coverage, insurance and financial services committee.

At stake is millions of dollars, as the program creates $300 million in savings annually for Maine health care providers, according to hospital officials.

The program requires drug companies to sell certain outpatient drugs at discounted rates to safety net programs that help rural, low-income and underserved populations. The goal of the 340B program is to take the savings from the discounted rates and reinvest the funds into safety net services and charity care.

But the hospitals argue that drug companies are exploiting loopholes in the federal law to get around providing the discount, such as restricting which pharmacies patients can use. Generally, the program is invisible to patients, as the discounts are given to health care providers to invest in safety net programs. Little or no state tax funds would be at stake, as the funding is entirely through the discounts.

One provision in the bill would forbid drug companies from restricting which pharmacies can participate in the 340B program.

The pharmaceutical industry contends that hospitals are exploiting the program by overcharging for the drugs, and then using the discount program to keep money that they shouldn’t be getting.

Stami Turk, spokesperson with the Pharmaceutical Research and Manufacturers of America, said in a written statement that “Maine lawmakers shouldn’t reward those who abuse the program by expanding it.”

The pharmaceutical industry is advertising heavily in Maine against the bill, with a number of television and online ads.

“340B is a significant revenue source for our mental health, substance use treatment and primary care services,” Dwyer said. “Pharma is cutting into our ability to provide rural health care.”

But the pharmaceutical industry argues that hospital systems are exploiting the system for financial gain.

“Large hospital systems are abusing the 340B program, and it’s leading to higher costs for patients, employers, and taxpayers. Now these same hospital systems want to expand the program in Maine,” Turk said.

The New York Times has published several articles about the pitfalls of the 340B program, including a January story that showed some hospitals charging insurance companies large markups for medications.

Meanwhile, an analysis released by the Maine Hospital Association this week paints a dire financial picture, showing operating losses and other financial problems at many Maine hospitals. Services have been cut, and Northern Light’s Inland Hospital in Waterville is closing.