NACDS Welcomes HHS-OIG Final Rule That Allows Medicare, Medicaid Patients to Access Pharmacy Reward Programs

| Dec-14-16

Arlington, Va. – The National Association of Chain Drug Stores (NACDS) is welcoming a final rule issued by the Department of Health and Human Services (HHS) Office of the Inspector General (OIG) that will allow pharmacies greater flexibility to extend their popular reward and loyalty programs to beneficiaries in government programs, including Medicare and Medicaid.

This is a very positive step forward for pharmacy patient care, and a further recognition by a government agency of the tremendous value of pharmacies as the face of neighborhood healthcare and of the expanded innovative programs that pharmacies provide.

The final rule reflects OIG’s acceptance of several of NACDS’ suggestions for important improvements to the final rules. NACDS had submitted formal comments to OIG during the development of the rule to express strong support for it in concept and to convey revisions that would be necessary for the rule’s workability.

“NACDS advocated for this rule, and worked constructively to help enhance it, because it will allow government program beneficiaries to enjoy access to programs voluntarily implemented by pharmacies which reduce healthcare costs, improve quality, and promote patient health,” said NACDS President and CEO Steven C. Anderson, IOM, CAE. “This is a very positive step forward for pharmacy patient care, and a further recognition by a government agency of the tremendous value of pharmacies as the face of neighborhood healthcare and of the expanded innovative programs that pharmacies provide.”

Federal laws have blocked participation by government-program beneficiaries in these initiatives offered by pharmacies, even though these initiatives have been enjoyed by other patients for many years. Programs vary in their specific designs. They often include cost-savings or other rewards for filling prescriptions or engaging in other health-promotion programs, such as health screenings or strategies designed to enhance medication adherence – or taking medications as prescribed.

“Pharmacy programs affected by the proposed rule reduce healthcare costs, both for individual patients and for the healthcare system as a whole. At the same time, these pharmacy programs promote access to prescribed medications that are essential to maintaining patient health and wellness,” NACDS explained in its comments submitted during the regulatory process.

“Failure to take medications as prescribed leads to major healthcare complications for patients and $290 billion in increased healthcare costs as a result of preventable physician visits and hospitalizations. Incentives to participate in medication adherence and other beneficial pharmacy programs have a demonstrated track record of increasing patient health while simultaneously decreasing overall healthcare costs.”

NACDS noted that non-government payers and patients have found these programs to be effective, without contributing to overutilization of care.

The final rule was issued on December 7, 2016, and takes effect on January 6, 2017.

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