Can a doctor or pharmacy be paid by a pharmaceutical manufacturer to make a prescription refill reminder without an individual’s prior authorization under the HIPAA Privacy Rule?


Yes, provided that any payments from the pharmaceutical manufacturer are reasonably related and limited to the covered entity’s cost of making the communication.  

  • For payments to the doctor or pharmacy, this means payments may cover only the reasonable direct and indirect costs related to the refill reminder or medication adherence program (or other excepted communications), including labor, materials, and supplies, as well as capital and overhead costs.
  • For payments to a business associate that contracts with a doctor or pharmacy to assist in carrying out the refill reminder or medication adherence program (or to make other excepted communications), this means payments (either directly from the pharmaceutical manufacturer or through the covered entity) may be only up to the fair market value of the business associate’s services.
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