OIG Announces Drug Pricing and Reimbursement Web Portfolio

On February 17, 2017 the Office of the Inspector General (OIG) posted a Drug Pricing and Reimbursement Web portfolio on its website that, according to the OIG announcement, “pulls together the HHS OIG’s body of work since 2010 as well as other relevant items that relate to drug pricing and reimbursement in HHS programs.” The portfolio showcases the OIG’s work in the drug pricing and reimbursement realm as drug pricing continues to be a political hot topic.

Overall, the portfolio includes OIG’s reports; implemented and unimplemented recommendations; summaries of civil monetary penalties and assessments against individuals and entities for prohibited conduct related to reporting requirements required under the Medicaid Drug Rebate Program; and OIG’s advisory statements and bulletins on a variety of drug pricing and reimbursement topics.

The portfolio should be monitored by plan sponsors, pharmaceutical companies, pharmacy benefit managers, and pharmacies, and others involved in drug distribution as a convenient location to find information published by the OIG that will impact their business. For example, the portfolio outlines future OIG report topics and their expected publication dates, such as the expected 2017 report on the quality of sponsor data used in calculating coverage gap discounts. Additionally, those in the industry can monitor and review OIG recommendations to HHS that, while unimplemented, can shed light on potential future enforcement areas.

Nicole Burgmeier

Nicole practices in the area of health law advising pharmacies, hospitals, long-term care providers, and medical practices on a variety of regulatory, compliance, and corporate transactional matters. She regularly advises on issues related to Medicare and Medicaid, state and federal privacy laws, state pharmacy laws, medical staff bylaws, tax-exempt status, certificate of need appeals, corporate structures and formation, and state and federal licensure.

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