tci Medicare Compliance & Reimbursement - 2005 Issue 44

PHARMACEUTICALS: PAPs Should Not Assist Too Much

Tread carefully when offering PAPs to Medicare Part D benes.Pharmaceutical providers that wish to offer patient assistance programs to help Medicare Part D beneficiaries get drugs may need to make donations through an independent charity to avoid violating fraud and abuse laws.A pharmaceutical manufacturer that uses its own PAP to subsidize its own Part D-payable products may risk fraud and abuse allegations, according to an HHS Office of the Inspector General Special Advisory Bulletin. "The bulletin makes clear that lawful avenues exist for pharmaceutical manufacturers and others to help ensure that all Part D beneficiaries can afford...

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