While pharmaceutical manufacturer brand teams often employ prescription co-pay savings card programs to promote medication adherence, federal law prohibits prescriptions funded by a government plan (e.g., Medicare, Medicaid) from receiving any prescription co-pay discount. Despite best efforts, preventing these discounts from being applied is a challenge. If it does occur, the risk exposure to the brand is a $25,000 fine per instance.

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The Centers for Medicare and Medicaid Services (CMS) has reinforced its intent to “identify safeguards pharmaceutical manufacturers have in place to ensure that beneficiaries do not use co-payment coupons to obtain prescription drugs paid for by Medicare Part D.”¹

Protect your pharmaceutical brand with electronic compliance safeguards

RelayHealth's SafeCardRx™ solution provides your pharmaceutical brand's card program with unmatched Office of Inspector General (OIG) compliance with this regulation in almost any pharmacy across the U.S. SafeCardRx helps prevent prescription co-pay savings cards and coupons from being applied to known government-funded prescriptions, in real-time at the point of dispensing.

Many compliance safeguards used today rely on the patient to abide by the disclaimer messaging printed on the card—a manual process with limited efficacy. SafeCardRx helps qualify the prescription electronically, while the claim is being adjudicated with the benefit processor and before any medication is dispensed.

Features of SafeCardRx:
  • Helps to electronically monitor and qualify prescriptions filled in pharmacies across the U.S.
  • Provides pharmacist messaging at the point of dispense indicating a co-pay savings cannot be applied
  • Proven technology already used by pharmaceutical brands of all sizes
We can help:
  • Strengthen your brand's OIG compliance efforts
  • Reduce pharmaceutical brand exposure to costly government sanctions

¹http://oig.hhs.gov/reports-and-publications/archives/workplan/2013/Work-Plan-2013.pdf (PDF, 1.3 MB).