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Abstract

Objective:

To discuss changes in the law that allow community pharmacy loyalty programs to include and offer incentives to Medicare and Medicaid beneficiaries.

Summary:

The retailer rewards exception of the Patient Protection and Affordable Care Act of 2010 and its change to the definition of remuneration in the civil monetary penalties of the Anti-Kickback Statute now allow incentives to be earned on federal benefit tied prescription out-of-pocket costs. The criteria required to design a compliant loyalty program are discussed.

Conclusion:

Community pharmacies can now include Medicare and Medicaid beneficiaries in compliant customer loyalty programs, where allowed by state law. There is a need for research directly on the influence of loyalty programs and nominal incentives on adherence.

Keywords

legislation health care reform community pharmacy Medicare Medicaid

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References

42 U.S.C.A. 1320a-7b(b)(2)(B).

Pub. Law 111-148, §6402(d)(2).

DHHS OIG Advisory Op. No. 12-14 (October 16, 2012).

42 U.S.C.A 1395y(a)(1)(A).

42 U.S.C.A. 1320a-7a.

Pub. Law 111-148.

132S.Ct. 2566 (2012).

42 U.S.C.A. 1320a-7a(i)6G.

Fleming

Nemlekar

Brown

. Exploratory study of community pharmacists’ perceptions about new or transferred prescription incentives. J Am Pharm Assoc. 2012;52(5):e53–e58.

10.

Shrank

Choudhry

Fischer

. The epidemiology of prescriptions abandoned at the pharmacy. Ann Intern Med. 2010;153(10):633–640.

The Affordable Care Act on Loyalty Programs for Federal Beneficiaries