Co-Payer Beware? OIG Report Cites Kickback Concerns With Part D Copay Coupons
This article was originally published in RPM Report
Executive Summary
An HHS Inspector General report finds that manufacturer safeguards may be inadequate to prevent copay coupon use in Medicare Part D. The finding puts CMS in a tricky position – how to limit any chance that coupons inducing use of high-priced brands without cutting off vital support for needy beneficiaries.
You may also be interested in...
Co-pay Coupons and the ACA: Despite HHS Ruling, Insurers Still Hold The Cards
The Obama Administration OKs the use of co-pay cards for brand prescription drugs in the ACA-created insurance exchanges. One prominent Republican intends to investigate the decision. But insurers and PBMs can decide whether or not to accept them—a fact being lost in the debate.
US Medicare Plans 'Can' Cover Wegovy, CMS Says, But Will They?
Medicare is making clear that Part D ‘can’ cover GLP-1 inhibitors that are approved for cardiovascular indications – but in language that seems to leave plans considerable discretion for now. The formulary review process for 2025 may be a more important milestone for changes.
An Artificial Intelligence Milestone For US FDA
A project to validate a depression severity measurement tool that employs artificial intelligence for use in drug trials is moving forward at FDA. The milestone is a sign of things to come – and of the incremental process for AI adoption by the regulator.