OIG Targets Part D Coupon Kickbacks, PBM Oversight

Federal officials will investigate this year the safeguards pharmaceutical companies have in place to keep Medicare Part D beneficiaries from using manufacturers’ coupons to pay copayments for their prescriptions, according to a recent report.

The project is one of several new Part D-related initiatives that the Department of Health and Human Service’s Office of Inspector General announced in its fiscal year 2013 Work Plan.  OIG explained that copay coupons encourage beneficiaries to buy more expensive drugs, thus driving up program costs.  The use of such coupons also implicates the federal Anti-Kickback Statute, OIG noted.

The office announced in its Work Plan several other new Part D projects, including one to assess how well plan sponsors are overseeing the work of their Pharmacy Benefits Managers.  Sponsors are responsible for making sure that their PBMs comply with all applicable Part D regulations and policy guidance from the Centers for Medicare & Medicaid Services.

To read more about the OIG’s new Part D projects and the rest of its planned work, please visit:

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