Compliance Statement


Compliance Statement

Franklin Technology Services LLC DBA LowerMyRx (“LowerMyRx” or “we” or “us”) is committed to legal and ethical business practices and it takes compliance with healthcare laws very seriously. But it doesn’t stop with us. Compliance is everyone’s responsibility! To this end, we require all personnel, vendors, contractors, and partners to review the following summary of key compliance issues related to our business offerings:

LowerMyRx expects you to conduct yourself in an ethical and legal manner. It’s about doing the right thing!

Act fairly and honestly

Adhere to high ethical standards in all that you do

Comply with all applicable laws and regulations, and

Report suspected violations:

  1. You can email support@lowermyrx.com.
  2. If you would prefer to make a confidential, anonymous report, you can use one of these reporting options:

1) Website:
www.lowermyrx.com/compliance-concerns/

2) Toll-Free Telephone:
(877) 202-1910

Failure to follow all applicable healthcare laws and regulations can lead to serious consequences, including:

Contract termination

Criminal penalties

Exclusion from participating in all Federal healthcare programs

Civil monetary penalties

 

Prescription Drug Discount Cards and Programs

Prescription discount card services are highly regulated by state and federal governments, and our compliance with these laws is not only monitored by government regulators, but also by our customers, competitors, and the public at large. In other words, someone is always watching.

LowerMyRx expects its employees, vendors, contractors, and partners to comply with all laws and regulations governing prescription drug discount cards. This includes providing clear and consistent information to discount card members, with particular regard to the following points:

  1. LowerMyRx offers a prescription drug discount card, either branded or white-labeled with a Affiliate’s own branding, and in the form of a physical card, a mobile app, a downloadable card or other mutually agreed format (the “Program”). The Program is NOT a health insurance policy or a substitute for health insurance.
  2. The Program allows members to obtain discounts on prescription drugs and/or pharmaceutical products purchased through participating pharmacies. The member is responsible for all payments to pharmacies from whom he or she receives a prescription discount. LowerMyRx does not make payments to any pharmacy, pharmacy employee, or healthcare provider.
  3. The price paid to the pharmacy is always the lesser of the LowerMyRx discounted price or the pharmacy’s retail price. If the pharmacy’s retail price is less than the LowerMyRx discounted price, there is no discount. Discounts are available only at pharmacies that participate with LowerMyRx. Participating pharmacies and all LowerMyRx pricing are subject to change without notice.
  4. The Program may not be used with other prescription drug discount cards or for prescriptions paid through a health plan or pharmacy benefit plan. If a member has health insurance or any other funded benefit such as Medicaid or Medicare, he or she can ONLY use the Program for certain prescriptions that are NOT covered by their plan.
  5. LowerMyRx does not offer insurance of any kind.
  6. LowerMyRx does not provide medical, dental, or other health-related services.
  7. The Program is offered to consumers free of charge.
  8. LowerMyRx does not make payments to any pharmacy, pharmacy employee, or healthcare provider.


Healthcare Fraud, Waste, and Abuse


The federal government and many state governments have adopted laws that prohibit conduct that can cause fraud, waste, and abuse in healthcare programs. Whether certain laws apply to a business arrangement or a product depends on the facts, by Franklin Technology Services LLC DBA LowerMyRx requires and expects its vendors, contractors, and partners to comply with these laws, consider the implications of them in all business dealings, and engage in ethical busines practices.

Fraud

(a) Is an intentional act of deception, misrepresentation, or concealment in order to gain something of value

(b) Often involves billing for services that were never rendered or billing for services at a higher rate than is actually justified.

Waste

(a) Is over-utilization of services and misuse of resources

(b) Is generally not considered to be caused by criminally negligent actions but rather by the misuse of resources

Abuse

(a) Is the excessive or improper use of healthcare services or actions that are inconsistent with acceptable business and/or medical practice

(b) Refers to incidents that, although not considered fraudulent, may directly or indirectly cause financial loss.

 

Laws Targeting Healthcare Fraud, Waste, and Abuse
To ensure appropriate business relationships, LowerMyRx requires its vendors, contractors, and partners to specifically refrain from the type of conduct prohibited by the following federal laws:

Anti-Kickback Statute

(a) The Anti-Kickback Statute makes it’s a criminal offense to knowingly offer or receive anything of value (e.g., money) to induce referrals of items or services payable by a federal healthcare program, such as Medicare or Medicaid. In some industries, it is acceptable to reward those who refer business to you. However, in the Federal healthcare programs, paying for referrals is a crime.

(b) A violation of the Anti-Kickback Statute can occur if any one purpose of the arrangement is improper, even if other purposes exist that do not implicate the Anti-Kickback Statute.

(c) Violations of the Anti-Kickback Statute may be criminal or civil and are punishable by imprisonment, substantial fines, or both. Most states have adopted laws that mirror the Anti-Kickback Statute and apply outside of federal healthcare programs.

 

Civil Monetary Penalties (CMP) Law

(a) Among other things, the CMP Law imposes civil fines on any person who offers or provides anything of value (e.g., money) to a Medicare or Medicaid beneficiary that is likely to influence the beneficiary’s selection of a particular provider or supplier for any item or service reimbursable by Medicare or Medicaid. Many states have adopted laws that mirror the CMP Law and apply outside of federal healthcare programs.

 

Healthcare Fraud Statute

(a) The Healthcare Fraud Statute makes it a criminal offense to knowingly and willfully execute a scheme to defraud a healthcare benefit program. Healthcare fraud is punishable by imprisonment up to 10 years. It is also subject to criminal fines of up to $250,000.

(b) Conviction under the statute does not require proof the violator had knowledge of the law or specific intent to violate the law.

 

How do you prevent fraud, waste and abuse?

  1. Look for suspicious activity
  2. Conduct yourself in an ethical manner
  3. Ensure accurate and timely data and billing
  4. Ensure coordination with other payers
  5. Know policies and procedures, standards of conduct, laws, regulations, and related guidance
  6. Verify all received information
  7. If you have questions or are concerned about potential compliance issues, reach out to our compliance team (support@lowermyrx.com).

(a) If you would prefer to make a confidential, anonymous report, you can use one of these reporting options:

  1. Website:
    www.lowermyrx.com/compliance-concerns/
  2. Toll-Free Telephone:
    (877) 202-1910

 

So . . . what CAN'T I do?


DON’T offer money, gifts, kickbacks, bribes or anything else of monetary value to doctors, nurses, pharmacists, pharmacy techs or interns, or other healthcare providers or pharmacy employees to promote LowerMyRx, the Program or any white-labeled service of LowerMyRx (or otherwise) or to enroll members in the Program or the LowerMyRx Program.

DON’T use ANY marketing materials that have not be pre-approved by LowerMyRx. That means web sites, physical cards, emails, faxes, flyers, text messages, apps or any other kind of marketing or solicitation materials you can think of.

DON’T use the trademarks, names, or logos of other businesses in your marketing materials unless you have the right (a license) to do so and unless your marketing materials have been approved by LowerMyRx.

DON’T imply or state that the Program is insurance coverage or a replacement for insurance. DON’T charge a fee for participation in the Program. The Program is free to consumers.
DON’T make any statements about the LowerMyRx Program that we have not expressly approved.

DON’T ignore compliance or think “Someone else is handling that.” Compliance is everyone’s responsibility, including yours.

 

So . . . what CAN I do?


DO engage in open and honest marketing efforts. Explain the value of doing business with the Program to offer prescription discounts.

DO communicate clearly regarding prescription drug discount cards and how the LowerMyRx program works.

DO report to LowerMyRx any instance in which you become aware of a pharmacist demanding or receiving money or anything of monetary value for agreeing to promote LowerMyRx, the Program or any competing managed pharmacy program.

DO take compliance seriously. Conduct yourself in an ethical and legal manner. Act fairly and honestly in all business dealings.

DO act in a manner that does not conflict with, contradict, or otherwise misrepresent LowerMyRx’s mission and vision.

DO ask questions! If you have questions or concerns, reach out to support@lowermyrx.com.


Data Use, Information Security & Privacy


LowerMyRx expects its vendors, contractors, and partners to protect all data and information related to LowerMyRx’s business; and to comply with all applicable laws pertaining to the confidentiality, privacy, data security, and data use as set forth in our agreements.


LowerMyRx Oversight


LowerMyRx may conduct oversight of the services you perform to ensure that you are complying with the requirements explained in this Compliance Standards and applicable laws, rules, and regulations. LowerMyRx may periodically ask you to complete a self-assessment, survey, and/or attest to applicable policy, procedure and compliance requirements. LowerMyRx may also perform on-site audits or inspections of facilities, procedures, and records that relate to the services provided under your contractual agreement.

 

Reporting Compliance Concerns
Reporting compliance concerns is everyone’s responsibility. You play a vital part in preventing, detecting, and reporting potential noncompliance. Please report any suspected cases of noncompliance without fear of retaliation or retribution for reports made in good faith:

  1. Contact our Compliance Team: support@lowermyrx.com
  2. To make a confidential, anonymous report, you can use one of these reporting options:

(a) Website:
www.lowermyrx.com/compliance-concerns/

(b) Toll-Free Telephone:
(877) 202-1910

By signing below, I certify that I read and understood the information provided in these Compliance Standards (the “Standards”) and certify that I commit to complying with all the laws and requirements they set forth.

I understand that any violation of these Standards is a violation of the terms and conditions of my Agreement with Franklin Technology Services LLC DBA LowerMyRx, and could result in the enforcement of legal remedies against me, including, but not limited to, termination of my Agreement with LowerMyRx and the forfeiture of any amounts due thereunder. I further understand that a violation of these Standards may also subject me to federal and state civil and/or criminal culpability.

I also understand that no statement contained in these Standards creates any guarantee of continued contract or employment, or creates any obligations, contractual or otherwise, on the part of LowerMyRx. These Standards are not promissory and do not set terms or conditions of employment or create an employment contract.


Compliance Attestation


Franklin Technology Services LLC DBA LowerMyRx (“LowerMyRx”) and the undersigned Affiliate have a mutual desire to maintain effective compliance and ethics programs in support of the pharmacies who administer the prescription discount program provided by LowerMyRx (the “LowerMyRx Program”) and the patients who use these programs. As evidence of this commitment, LowerMyRx seeks to confirm the Affiliate’s efforts as a compliment to the contractual obligations between the parties (which remain in full force and effect and unmodified hereby).

For purposes of this attestation, Affiliate represents and warrants the following:

  1. The Affiliate, including any person or entity with whom the Affiliate has contracted in connection with the LowerMyRx Program (its “Contractors”), adheres to all applicable local, state, and federal rules and regulations, including, without limitation, those applicable to the LowerMyRx Program and their distribution thereof.
  2. The Affiliate will monitor its operations and those of all of its Contractors for any activities which may create conflict, disruption, or improper inducement or incentives that are inconsistent with the purpose and operations of the Program.
  3. The Affiliate will monitor its operations and those of its Contractors for any activities which may interfere with or jeopardize any relationship between LowerMyRx and any third parties, including eligible pharmacies in the LowerMyRx Program.
  4. Where the Affiliate enters into agreements with a pharmacy that utilize the LowerMyRx Program but creates other financial or reimbursement arrangements, the Affiliate shall immediately disclose such an arrangement to LowerMyRx.
  5. The Affiliate has a mechanism for receiving concerns, complaints or reports of misuse and a process for escalating issues to LowerMyRx where there is any impact on any claims or with respect to any pharmacy.
  6. The Affiliate has incorporated standards of this attestation into is Contractor agreements in a manner which represents substantially similar obligations by the Contractor.
  7. Where the Affiliate sanctions or otherwise alters its relationship with a Contractor due to compliance or ethics concerns, the Affiliate shall immediately notify LowerMyRx to the extent that such a relationship relates to or impacts the LowerMyRx Program in any way and where such action is not deemed confidential.
  8. Where the Affiliate is being sanctioned by any pharmacy or otherwise prohibited from conducting operations at any pharmacy due to compliance or ethics concerns, the Affiliate shall notify LowerMyRx immediately.

The Affiliate attests that it is upholding these compliance and ethics standards and that the Affiliate has disclosed applicable impacts to LowerMyRx.

 

Affiliate

 

CONFIDENTIAL

 

 

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Signature Certificate
Document name: Compliance Statement
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March 5, 2021 6:23 pm ESTCompliance Statement Uploaded by Philip Venticinque - support@lowermyrx.com IP 71.188.51.157