At Long Last, OIG Issues Final Rule for Beneficiary

Coupons, Rebates, and Other Retailer Reward Programs. The Final Rule also codified the ACA exception permitting retailers (i.e., an entity that sells items directly to consumers) to offer or transfer coupons, rebates, or other rewards (including store merchandise, gasoline, or frequent flyer miles) for free or less than fair market value if the

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Senate Finance Committee Passes Drug Pricing Bill Mintz

Senators Chuck Grassley (R-IA) and Ron Wyden (D-OR), Chairman and Ranking Member (respectively) of the Senate Finance Committee, have fired the latest shot in Congress’s ongoing battle against high drug prices. Last week, the Senators introduced their much-anticipated proposal to lower drug prices: a chairman’s mark called the Prescription Drug Pricing Reduction Act (PDPRA) of 2019.

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CMS Proposed Rules for Reporting AMP and Best Price May

Depending on specific circumstances and the type of drugs involved, the Medicaid drug rebate that pharmaceutical manufacturers must pay to the 51 State Medicaid Programs is either the difference between the AMP and the Best Price for that specific drug and dosage, or is tied to a specific percentage off of the calculated AMP.

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State and Federal Pharmaceutical Enforcement Litigation

State prosecutors are still pursuing AWP cases and believe state enforcement efforts regarding off-label marketing will only increase. Indeed, Cynthia O’Keefe, who heads a litigation team for the Texas Civil Medicaid Unit, stated her success has energized her unit and other state Attorneys General to pursue more off-label cases.

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