On February 6, the HHS Office of Inspector General formally published in the Federal Register its proposed changes to remove PBM rebates from the existing discount safe harbor, and new exceptions for point-of-sale rebates and certain payments from manufacturers to PBMs. These changes have the potential to upend the current PBM rebate framework for prescription drugs.
Everyone will feel the impact of these changes as they ripple through the industry, but health systems that operate self-insured plans will want to take particular notice. Comments on the Proposed Rule are due April 8, 2019. POWERS Healthcare Principal, Mark Fitzgerald and Healthcare Associate, Megan La Suer, have prepared a brief summary of the new rule, which can be found here.