At the annual Food and Drug Administration conference, Commissioner Scott Gottlieb suggested the federal laws that protect rebates circulated between pharmacy benefit managers, insurance companies, and drug manufacturers are due for a change. He offered that drug rebates currently protected by the federal government are partly to blame for rising medication costs and revamping the rebate system will increase competition and reduce prices for the consumer.
As the system exists now, pharmaceutical companies set the list price of a drug, which is usually quite high. They issue a system of rebates for health plans, essentially lowering the cost of the drug in return for greater access to patients. Gottlieb criticizes this system, claiming it prevents competition among manufacturers and forces drug prices to rise. He wants the government to call rebates, kickbacks, and hold them accountable to the Anti-Kickback Statute.
The Anti-Kickback Statute is a federal law prohibiting the exchange or offer to exchange something of value to induce the referral of health care business. The law punishes parties on both sides of the equation with a fine of up to $25,000 and incarceration for up to five years for a single violation. Conviction also includes mandatory exclusion from participation in government health programs.
Call for Change
Some members of the current administration and Congress are calling for insurers and pharmacy benefit managers to pass their rebates on to consumers, many of whom are burdened with rising co-pays and deductibles. Health and Human Services Secretary, Alex Azar, wants to revise the pricing paradigm in Medicare Part D to bring down prices on outpatient drugs. The proposed change is just one part of a comprehensive plan the administration is working on to make prescription medication more affordable for Americans.
Several drug companies are currently facing lawsuits alleging the rebates they issue to pharmacies to benefit managers and insurance companies are really kickbacks. Many doctors fear they will become entangled in the same debate and sued for accepting kickbacks.
Philadelphia Health Care Lawyers at Sidney L. Gold & Associates, P.C Protect Physicians from Kickback Lawsuits
Physicians who violate the federal Anti-Kickback Statute face grave consequences. Philadelphia health care lawyers at Sidney L. Gold & Associates, P.C. represent doctors accused of violating anti-kickback laws. We thoroughly investigate every aspect of your case and gather all the documentation available to prove your compliance. Until the federal government clarifies or revises the current rebate system, consumers may wrongly believe their doctor is to blame for unreasonable drug prices. We work diligently to protect you and your business against kickback claims.
Call 215-569-1999 or complete the online contact form to schedule a consultation today. We are conveniently located in Philadelphia, Pennsylvania, and our attorneys are proud to serve clients in and around Bucks County, Chester County, Delaware County, and Montgomery County.