/
PATIENT SERVICES, INC. PATIENT SERVICES, INC.

PATIENT SERVICES, INC. - PowerPoint Presentation

olivia-moreira
olivia-moreira . @olivia-moreira
Follow
386 views
Uploaded On 2016-05-22

PATIENT SERVICES, INC. - PPT Presentation

Overcoming New Challenges to Patient Assistance Presentation to RDLA Thursday October 16 2014 Background Leading to May 21 2014 Special Advisory Bulletin OIG One NPO exceeded the OIG guidelines ID: 330333

patient oig drug 2014 oig patient 2014 drug defined patients drugs bulletin advisory special funds high single letter assistance

Share:

Link:

Embed:

Download Presentation from below link

Download Presentation The PPT/PDF document "PATIENT SERVICES, INC." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.


Presentation Transcript

Slide1

PATIENT SERVICES, INC.“Overcoming New Challenges to Patient Assistance”

Presentation to RDLA

Thursday, October 16, 2014Slide2

Background Leading to May 21, 2014 Special Advisory Bulletin (OIG)One NPO exceeded the OIG guidelinesBarron’s Oct 18, 2013/ Oct 22, 2013 Seeking Alpha publicationsSingle Rx program increased donors quarterly cash dividends by 20%. Acthar for MS

Created alleged fraud and abuse

Report reached Dept. of Justice, DOJ inquired of OIG who granted opinion Slide3

Compliance is a High Priority(New Office of Inspector General Special Advisory Bulletin, May 21, 2014)1. Disease Funds will…

a. Be legitimately defined in accordance with “widely recognized clinical standards” (e.g. FDA, CMS???)

b. Be defined “in a manner that covers within each fund a broad spectrum of products wherever possible including generics”.

c. “Not be defined by reference of specific symptoms, severity of symptoms, method of administration, stages of particular disease, type of drug treatment, or any other way of narrowing”

d. Not be defined as “high

cost or specialty drug

funds” and must consider

other financial variables beyond

income

(e.g. costs of

living, debt)

Slide4

Compliance is a High Priority(New Office of Inspector General Special Advisory Bulletin, May 21, 2014)2. No single-drug funds… a. Providing copayment for only one drug or only one manufacturer.

b. Unless fund is

legitimately defined

, includes combining two or more related disease funds, covers any drugs needed by patient, covers all copayments for items and services needed by patients and is

submitted for consideration to OIG on a case by case basis

.

Slide5

Compliance is a High Priority(New Office of Inspector General Special Advisory Bulletin, May 21, 2014)3. Diluting Funds May Be Acceptable… a.

According to legal counsel

discussions

with OIG,

OIG may consider single drug

funds if they

are

“diluted”.

(1). Dilution means: Premium , Copayment, Travel

Expenses

,

and

Ancillary Expenses (Nursing, labs,

diagnostic

test,

physician copays, infusion costs, etc.)

4.

Reporting

must be OIG compliant and not correlate donation amount with patient usage

Slide6

Consequences to Manufacturers and PatientsManufacturers Add more drugs to the “fund” including generics –supporting other drugsAdd premium assistance if a “copayment” program

Provide “copayment” assistance for only private patients

If single donor program; dilute with copay, premium, travel expense, ancillary services

Patients

No access to rare and orphan drugs

Barrier to assistance: adverse health; life/death

Most vulnerable populations (Medicare beneficiaries); establishes a class medical society

Slide7

PSI Legislative ResponseDevelop partnership with patient communitiesDeveloped bipartisan letter CongressWorking with Caucus Co-Chair Leonard Lance & Congresswoman Matsui to anchor letter

Met with Congressional Offices regarding issue including House Majority Whip, Steve

Scaliece

(R-LA)Slide8

What Can Your Organization Do to Help? Sign Organizational Support Letter to Congressman Leonard Lance (R-NJ).Work with PSI to activate patient advocates to send letters to Members of Congress.