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Kickback guidelines proposed

  IMDA members should pay attention to recently published federal guidelines regarding kickbacks. Although the guidelines, issued in early October by the Office of the Inspector General of the Department of Health and Human Services, pertain to drug manufacturers, they could find their way into the medical device sector as well.
  The draft compliance guidelines for pharmaceutical manufacturers are meant to help drug companies and their sales reps follow anti-kickback statutes, which prohibit the offer or payment of anything in value to induce healthcare providers to buy drugs or products that are reimbursable by Medicare or Medicaid. They were published in the Federal Register (Oct. 3, Vol. 67, No. 192, or on the Web at www.oig.hhs.gov.).
  “Though the regulations are principally directed to pharmaceutical manufacturers, they may be read to apply to other companies that market products considered pharmaceuticals and biomedicals,” wrote IMDA Legal Counsel Mitchell Kramer in an Oct. 31 memo to the IMDA board. “Specific types of conduct that may be impermissible under these regulations include consulting and advisory payments, payments for entertainment, recreation, travel and meals; sponsoring educational conferences; funding scholarships, etc. to healthcare providers and others who influence the decision to purchase products.
  “In addition, as we have addressed in the past, the anti-kickback regulations can be broadly read to prohibit entirely the payment of commissions for the sale of medical products. As many of you know, this has been a matter of ongoing concern to IMDA.”

Discounts a sticky issue
  The guidelines state that manufacturers can potentially be in violation of anti-kickback laws when they offer wholesalers “concessions or benefits…to induce the wholesaler to purchase the products and to recommend the products to, or arrange for the purchase of the products by, customers that submit claims to the Federal health care programs.” Moreover, “incentive payments” made to group purchasing organizations may also put manufacturers in hot water.
 
Discounts are OK if:

  But according to the guidelines, “Other kinds of price concessions – including discounts on other products, other free or reduced-price goods or services, ‘educational’ or other grants, ‘conversion payments,’ signing bonuses, or ‘up-front rebates’) do not qualify for the discount exception and should be carefully reviewed.
  “Arrangements involving…non-price terms should be evaluated on a case-by-case basis. Arrangements that may increase the risk of overutilization, higher government program costs, inappropriate steering of Federal health care business, or unfair competition are particularly suspect.”

Checklist
  The OIG advises vendors to review all arrangements with the following issues in mind:

  IMDA members and others are encouraged to give the feds their opinions about the proposed guidelines. They must be delivered to the following address no later than 5 p.m. on Dec. 2: Office of Inspector General, Department of Health and Human Services, Attention: OIG-8-CPG, Room 5246, Cohen Building, 330 Independent Avenue SW, Washington, DC 20201.

 

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