Health Law Advisor

On July 2, 2025, the Department of Health and Human Services Office of Inspector General (OIG) issued Advisory Opinion 25-07 (AO 25-07), a favorable advisory opinion involving sponsored tests.

Sponsored tests are medical diagnostic tests or laboratory services whose cost is directly or indirectly paid for, in whole or in part, by a third party (often a pharmaceutical manufacturer or medical device company or related company), rather than by the patient, their insurance, or the health care provider performing the test. Typically, companies agree to pay for sponsored tests because they are necessary for a patient to access or use the company’s therapy but pose high out of pocket costs on the patient. Sponsored tests are frequently used to help match a patient to a specific drug or therapy available from the pharmaceutical manufacturer or medical device company, including true companion diagnostics, or to monitor therapeutic efficacy or to identify dangerous side effects of a prescribed therapy.  

The OIG previously issued two opinions, AO 24-12  and AO 22-06, that approved sponsored test arrangements in which pharmaceutical manufacturers offered free genetic testing and genetic counseling services to patients suspected of having rare conditions for which the manufacturers produced approved medications. Under the facts in these opinions, the genetic test results alone did not directly determine whether the manufacturer's drug would be prescribed.

On June 30, 2025, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services posted Advisory Opinion 25-05 (AO 25-05) to its website. AO 25-05 is a favorable opinion that allows a medical device manufacturer to reimburse purchasers of its device for actual costs up to $2,500 incurred from needle stick injuries caused by failure of the device without running afoul of the federal Anti-Kickback Statute (AKS).

According to AO 25-05, the device at issue is used to administer immunizations and other drugs to patients via injections and is more expensive than typical needles. The device has a safety mechanism to protect the user that covers the needle except when the needle penetrates patient tissue during the injection. When users experience a needle stick injury, their employers usually cover the associated costs, including retraining staff, staff absences and replacement, counseling for injured workers, and possible additional costs in the event of a lawsuit or higher insurance premiums or workers compensation premiums.

Artificial Intelligence (“AI”) applications are powerful tools that already have been deployed by companies to improve business performance across the health care, manufacturing, retail, and banking industries, among many others. From largescale AI initiatives to smaller AI vendors, AI tools quickly are becoming a mainstream fixture in many industries and will likely infiltrate many more in the near future.

But are these companies also prepared to defend the use of AI tools should there be compliance issues at a later time? What should companies do before launching AI tools ...