Cost Sharing Program In Part D From Coalition Of Cancer Drug Manufacturers Rebuffed By OIG

Federal watchdog group acknowledges proposed assistance program aligns with comments in a 2005 OIG advisory bulletin on patient assistance programs in Medicare Part D, but maintains the bulletin should not serve as a roadmap for a compliant program in this case.

Program Would Cover 90% Of Oncology Drug Use In Part D • Source: Shutterstock

A proposed cost sharing assistance program for oncology drugs in Medicare Part D that would be funded by a coalition of manufacturers and administered by an intermediary “would generate prohibited remuneration if the requisite intent were present, which would constitute grounds for the imposition of sanctions” under the federal anti-kickback statute, the US Health and Human Services Department’s Office of Inspector General concluded in an advisory opinion posted on 5 October.

The OIG said it is not in a position to evaluate the program sponsors’ intent because that is beyond the...

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