Bausch + Lomb Colleagues have a responsibility to communicate honestly about the financial aspects of our products, enabling healthcare professionals to make fully informed decisions. Therefore, it is appropriate for sales colleagues to use
Bausch + Lomb-approved materials when discussing topics such as formulary status, savings programs, health plan coverage, or utilization management programs with HCPs.
Bausch + Lomb Colleagues have a responsibility to communicate honestly about the financial aspects of our products, enabling healthcare professionals to make fully informed decisions. Therefore, it is appropriate for sales colleagues to use
Bausch + Lomb-approved materials when discussing topics such as formulary status, savings programs, health plan coverage, or utilization management programs with HCPs.
The following guidance pertains to Bausch + Lomb’s provision of reimbursement assistance to healthcare professionals or other customers, where relevant to their brands and markets. All reimbursement assistance must comply with applicable laws and regulations. Any questions about reimbursement assistance should be directed to the appropriate reimbursement or marketing teams.
The following guidance pertains to Bausch + Lomb’s provision of reimbursement assistance to healthcare professionals or other customers, where relevant to their brands and markets. All reimbursement assistance must comply with applicable laws and regulations. Any questions about reimbursement assistance should be directed to the appropriate reimbursement or marketing teams.
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Bausch + Lomb supports accurate and responsible billing to Medicare, Medicaid, and other PayFrs by providing healthcare professionals (HCPs) with truthful, accurate, and non-misleading information derived from published, authoritative sources.
To minimize errors and compliance risks, only designated, specially trained individuals—referred to in this Guide as Reimbursement Specialists—are permitted to provide detailed reimbursement information to HCPs. Sales representatives may only offer an accurate summary of publicly available data from trusted sources, such as procedure and diagnosis code descriptions and billing and coverage information from Centers for Medicare & Medicaid Services (CMS), insurance carriers, healthcare programs, Medicaid programs, other PayFr, and official coding authorities like the AMA’s CPT® Information Services. Sales colleagues should forward any reimbursement inquiries outside their approved materials to appropriate resources or to a Reimbursement Specialist when available.
Bausch + Lomb supports accurate and responsible billing to Medicare, Medicaid, and other PayFrs by providing healthcare professionals (HCPs) with truthful, accurate, and non-misleading information derived from published, authoritative sources.
To minimize errors and compliance risks, only designated, specially trained individuals—referred to in this Guide as Reimbursement Specialists—are permitted to provide detailed reimbursement information to HCPs. Sales representatives may only offer an accurate summary of publicly available data from trusted sources, such as procedure and diagnosis code descriptions and billing and coverage information from Centers for Medicare & Medicaid Services (CMS), insurance carriers, healthcare programs, Medicaid programs, other PayFr, and official coding authorities like the AMA’s CPT® Information Services. Sales colleagues should forward any reimbursement inquiries outside their approved materials to appropriate resources or to a Reimbursement Specialist when available.
Only Bausch + Lomb practice management and reimbursement specialists are authorized to provide detailed reimbursement guidance or assistance to HCPs and other customers, in compliance with all relevant laws, regulations, and guidelines.
Only Bausch + Lomb practice management and reimbursement specialists are authorized to provide detailed reimbursement guidance or assistance to HCPs and other customers, in compliance with all relevant laws, regulations, and guidelines.
Sales colleagues may discuss reimbursement topics only when aligned with the current approved product labeling (PI) and contained within Bausch + Lomb-approved materials. All reimbursement education and guidance must be based solely on published coding and reimbursement guidance from authoritative sources and factual managed care plan requirements. Formulary drug lists directly sourced from managed care plans or third parties and approved by Bausch + Lomb may be shared with physicians, provided they remain unaltered (e.g., no highlighting or underlining). All information must be truthful, accurate, and non-misleading.
Sales colleagues may discuss reimbursement topics only when aligned with the current approved product labeling (PI) and contained within Bausch + Lomb-approved materials. All reimbursement education and guidance must be based solely on published coding and reimbursement guidance from authoritative sources and factual managed care plan requirements. Formulary drug lists directly sourced from managed care plans or third parties and approved by Bausch + Lomb may be shared with physicians, provided they remain unaltered (e.g., no highlighting or underlining). All information must be truthful, accurate, and non-misleading.
Bausch + Lomb colleagues may provide general coding information (e.g., ICD codes, J-codes) only if it has received corporate approval through Bausch + Lomb’s promotional review process.
Coding decisions are the responsibility of the HCP, based on an independent assessment of the patient’s condition. Bausch + Lomb’s policy prohibits offering specific coding recommendations.
Bausch + Lomb colleagues may provide general coding information (e.g., ICD codes, J-codes) only if it has received corporate approval through Bausch + Lomb’s promotional review process.
Coding decisions are the responsibility of the HCP, based on an independent assessment of the patient’s condition. Bausch + Lomb’s policy prohibits offering specific coding recommendations.
All reimbursement materials intended for distribution to customers—such as reimbursement manuals, coding sheets, coverage summaries, communications, or summaries of benefit changes—as well as items directed to PayFr or policymakers (e.g., correspondence, presentations about coverage, coding, or payment policies or products) must be reviewed and approved through Bausch + Lomb’s promotional review process before being distributed. Any notices related to changes in payer policies must be reviewed and approved by the Legal Department.
All reimbursement materials intended for distribution to customers—such as reimbursement manuals, coding sheets, coverage summaries, communications, or summaries of benefit changes—as well as items directed to PayFr or policymakers (e.g., correspondence, presentations about coverage, coding, or payment policies or products) must be reviewed and approved through Bausch + Lomb’s promotional review process before being distributed. Any notices related to changes in payer policies must be reviewed and approved by the Legal Department.
Communications with PayFr Sales colleague discussions regarding medicines managed through a Buy & Bill process should be for the purposes of educating HCPs on the clinical features and risks of our medicines for the benefit of their patients. Discussions on reimbursement and market access matters, including but not limited to, discussions relating to contracting terms, billing, or coding, should be limited to Bausch + Lomb-approved messaging and information in Bausch + Lomb-approved materials., including government PayFr Sales colleague discussions regarding medicines managed through a Buy & Bill process should be for the purposes of educating HCPs on the clinical features and risks of our medicines for the benefit of their patients. Discussions on reimbursement and market access matters, including but not limited to, discussions relating to contracting terms, billing, or coding, should be limited to Bausch + Lomb-approved messaging and information in Bausch + Lomb-approved materials. and advocacy groups, must comply with all Bausch + Lomb policies and procedures. Only authorized personnel, such as those in Managed Markets, are permitted to engage in these communications.
Communications with PayFr Sales colleague discussions regarding medicines managed through a Buy & Bill process should be for the purposes of educating HCPs on the clinical features and risks of our medicines for the benefit of their patients. Discussions on reimbursement and market access matters, including but not limited to, discussions relating to contracting terms, billing, or coding, should be limited to Bausch + Lomb-approved messaging and information in Bausch + Lomb-approved materials., including government PayFr Sales colleague discussions regarding medicines managed through a Buy & Bill process should be for the purposes of educating HCPs on the clinical features and risks of our medicines for the benefit of their patients. Discussions on reimbursement and market access matters, including but not limited to, discussions relating to contracting terms, billing, or coding, should be limited to Bausch + Lomb-approved messaging and information in Bausch + Lomb-approved materials. and advocacy groups, must comply with all Bausch + Lomb policies and procedures. Only authorized personnel, such as those in Managed Markets, are permitted to engage in these communications.
The Buy & Bill process involves physicians or other care sites (e.g., hospitals, infusion centers) purchasing drugs from manufacturers or distributors, managing inventory, administering the drug, collecting patient cost-sharing if applicable, and submitting claims to PayFr for reimbursement of both the drug and related professional services.
The Buy & Bill process involves physicians or other care sites (e.g., hospitals, infusion centers) purchasing drugs from manufacturers or distributors, managing inventory, administering the drug, collecting patient cost-sharing if applicable, and submitting claims to PayFr for reimbursement of both the drug and related professional services.
Sales colleague discussions regarding medicines managed through a Buy & Bill process should be for the purposes of educating HCPs on the clinical features and risks of our medicines for the benefit of their patients. Discussions on reimbursement and market access matters, including but not limited to, discussions relating to contracting terms, billing, or coding, should be limited to Bausch + Lomb-approved messaging and information in Bausch + Lomb-approved materials.
Sales colleague discussions regarding medicines managed through a Buy & Bill process should be for the purposes of educating HCPs on the clinical features and risks of our medicines for the benefit of their patients. Discussions on reimbursement and market access matters, including but not limited to, discussions relating to contracting terms, billing, or coding, should be limited to Bausch + Lomb-approved messaging and information in Bausch + Lomb-approved materials.
Any discussion about a customer’s profitability or personal gain related to a Buy & Bill product is inappropriate. Specifically, “Marketing the Spread” is strictly prohibited for all products, including Buy & Bill items. The “spread” refers to the difference between the price a customer pays for a product and the amount received when reselling the product to the patient or other payers. Marketing the spread includes activities such as sales colleagues promoting this difference as a reason for healthcare professionals or customers to purchase the product or highlighting or guaranteeing a specific profit or margin associated with the customer’s purchase of the product.
Any discussion about a customer’s profitability or personal gain related to a Buy & Bill product is inappropriate. Specifically, “Marketing the Spread” is strictly prohibited for all products, including Buy & Bill items. The “spread” refers to the difference between the price a customer pays for a product and the amount received when reselling the product to the patient or other payers. Marketing the spread includes activities such as sales colleagues promoting this difference as a reason for healthcare professionals or customers to purchase the product or highlighting or guaranteeing a specific profit or margin associated with the customer’s purchase of the product.
For more information, please refer to Government Price Reporting, Average Wholesale Price (AWP) and Medicare Part D in the Healthcare Laws, Regulations and Guidelines section of the US Summary of Healthcare Laws guidance.
For more information, please refer to Government Price Reporting, Average Wholesale Price (AWP) and Medicare Part D in the Healthcare Laws, Regulations and Guidelines section of the US Summary of Healthcare Laws guidance.
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