PBMs Seek Safe Harbor Under Anti-Kickback Law

PBMs Seek Safe Harbor Under Anti-Kickback Law

August 1, 2024, Law360

Rujul Desai’s commentary was included in a Law360 article exploring how pharmacy benefit managers (PBMs) may be responding to a new federal anti-kickback law. Rujul explains how the anti-kickback law has multiple safe harbors —including the discount safe harbor, the group purchasing organization (GPO) safe harbor, and the services safe harbor — that PBMs and GPOs could use concurrently to shelter different types of financial payments.

“For example, a PBM GPO may potentially shelter administrative fee revenue under the GPO safe harbor and rebate payments under the discount safe harbor,” he observed. Rujul added that he wouldn't opine on whether the GPOs are complying with the safe harbors under the anti-kickback statute, but he said that “each of these safe harbors has its own unique requirements that must be thoughtfully complied with in order to shelter payments under the AKS.”