Activity Description : Health care providers, including infusion pharmacies, are highly regulated by federal and state laws. This is because a large portion of the reimbursement paid to infusion pharmacies is directly/indirectly tied to taxpayer money through Medicare, Medicaid, TRICARE, and FEHB programs, among others. Regarding marketing and referral source arrangements for infusion pharmacies, what is acceptable in the non-health care world is more carefully scrutinized in the health care world. Infusion pharmacies have hustled to grow their business through paid sales representatives, independent marketers, online presence, innovative arrangements with physicians, referrals through telemedicine, and other marketing arrangements. We will discuss (i) the federal anti-kickback statute, (ii) the federal physician self-referral statute (“Stark”), (iii) the federal beneficiary inducement statute, (iv) HIPAA marketing restrictions and (v) examples of their state counterparts especially the state kickback statutes. We will address numerous innovative marketing arrangements that infusion pharmacies utilize and address what works and what is unacceptably risky. Equally as important, this program will discuss (i) proper and questionable marketing programs, (ii) the types of arrangements that pharmacies can enter into with physicians, hospitals, home health agencies, and other referral sources, and (iii) the types of referral source arrangements that should be avoided.

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