
Health centers manage the health of their patients, including by prescribing drugs or helping patients fill prescriptions. Too often, patients encounter affordability issues at the pharmacy counter, whether because they are uninsured or have a high cost-sharing obligation. Though health centers might want to deploy resources to help their patients obtain their prescribed medication, state and federal fraud and abuse laws including the antikickback statute and patient inducement civil monetary penalty can create risk for well-intentioned actions. In addition, health centers are required to ensure that low-income patients who are uninsured or who have substantial cost-sharing obligations receive injectable epinephrine and insulin at discounted prices.
This session describes the challenges inherent in helping patients afford their medication and discusses strategies for complying with Notice of Award terms and assisting patients without triggering compliance risks.
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