The U.S. Department of Health and Human Services, Office of Inspector General (OIG) has issued an Advisory Opinion in which it approved store rewards program that allows customers to earn gasoline discounts based on purchases made at an in-store pharmacy.
OIG found that the program would not violate the anti-kickback law.
The requestor is a company that operates 13 supermarkets, most of which have in-store pharmacies. The company offers customers a store card that allows them to earn discounts on gasoline purchases. For every $10 a customer spends in the store, the customer is entitled to one cent per gallon off a single purchase of gasoline. The requestor wanted to implement a program whereby customers would receive similar discounts on out-of-pocket pharmacy costs. Under the proposed program, customers would not receive an extra bonus or reward for transferring prescriptions, nor would their prescription dollars generate higher rewards than money spent on groceries.
OIG concluded that – for two reasons – the program would pose only a minimal risk of fraud and abuse, and thus OIG would not impose sanctions in connection with the anti-kickback law.
First, there is a low risk that the program would direct beneficiaries to the Requestor’s stores to purchase federally reimbursable items or services, because:
(1) the stores in question are general supermarkets selling a broad range of groceries;
(2) customers wouldn’t be required to purchase prescription items to earn rewards; and (3) there is no special reward for transferring prescriptions.
Secondly, the rewards program is not likely to result in increase costs to federal healthcare programs, because:
(1) any cost-sharing amounts included toward a customer’s rewards would result from prescription drugs already prescribed;
(2) the program would not involve waivers or reductions in cost-sharing amounts; and
(3) the rewards were modest and would only be redeemable for gasoline purchases, which is not reimbursable by federal healthcare programs.
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