Meals

Legislation: Not applicable. 

MA Code of Conduct

Any hospitality (food and beverages) provided by a company to a HCP must be moderate, reasonable and commensurate with the activity as judged by local standards.

Legislation: Not applicable. 

MA Code of Conduct

In Australia, a maximum limit of AUD$140 per person (excluding GST and gratuities) per meal applies.  This cap should generally be reserved for events with significant education and duration.  For example, it is not expected that breakfast or lunch would reach the maximum limit, nor would a company be expected to reach the limit for a small event where educational content is delivered by company personnel.

Companies should plan that any meal (food and beverages) provided in another country complies with the monetary limit set by the industry association in that country (where applicable) or, if there is no monetary limit in that country, the Australian principles apply.

Legislation: Not applicable.

MA Code of Conduct

Other than the monetary limit (AUD$140), there are no specific restrictions on where meals can be provided.  However, meals cannot be provided to a HCP in the HCP’s home.

Legislation: Not applicable.

MA Code of Conduct

Prescription pharmaceutical companies may only provide hospitality (food and beverages) if it is secondary to the purpose of an activity.

A company is ultimately responsible for what is ordered and should implement some controls as to what can be ordered and how.

Alcohol may be provided at meetings held outside a medical institution or clinic, but should be limited to modest beer, wine or equivalents.  Hard liquor and cocktails would be considered to detract from the educational nature of the event and to be contrary to the overarching principles of the MA Code of Conduct.

Alcohol should not be provided to a HCP during a sales call.

Meals can only be offered during, or immediately before and/or following the scientific activities of events.

In this regard, for non-virtual events at least six hours per day must be devoted to scientific activities, during normal office hours. Three hours may, however, be acceptable for the first and the last day to facilitate arrival and departure.

The following limits apply at all times:

• EUR45 maximum per lunch, including drinks;
• EUR90 maximum per dinner, including drinks;
• EUR23 maximum per coffee break.

In addition, a maximum of EUR135 per day with at least six hours of scientific activities must be taken into account. If a day does not include six full hours of scientific activities, a total maximum of EUR23 per full hour of pure science may be spent on meals.

No Specific obligations apply, except that venues known for their entertainment or extravagancy must be avoided.

Statutory Laws

No specific rules. Any specifics must be assessed on the case-by-case basis.

INTERFARMA

Expenses with meals must be limited to the occasions inherent to the event itself and be directed exclusively to the invited professional and may be extended to the days immediately before and after the official schedule, if logistical and transport aspects justify such concession.

The offer of conveniences by the Company or Adherent during the events, including (but not limited to) lunches and snacks, must be done in a manner consistent with a good conduct and organization, and always compatible with the dignity and respectability of professionals participating.

The payment of meals to Healthcare Professionals is allowed when made for the purpose of discussion or exchange of scientific or educational information and must be limited to modest amounts and in a suitable place (for the conversation). The Company’s representative must be present during the entire time reserved for the meeting.

SINDUSFARMA

Members can sponsor or reimburse expenses with food of the health area professionals in national and international events, during the period of the event, which can be extended to the days immediately prior to or after the official agenda, for logistics, locomotion and transportation purposes that will justify granting this sponsorship.

ACESSA

The payment of meals to health professionals or health area-related professionals is allowed when conducted with the objective of discussing or exchanging scientific or educational information and must be limited to modest values and a place compatible with the exchange of information. The Associate Company’s representative must be present throughout the time reserved to the meeting.

Occasional reasonable ‎meals/refreshments may be ‎offered to HCPs.

The provision of ‎meals/refreshments must be ‎ancillary to the activity associated ‎with it.‎

Provision of reasonable meals and ‎refreshments is considered acceptable as long as the primary objective of the interaction is to facilitate business discussions.

Under no circumstances can meals ‎and refreshments be extended to spouses/companions ‎or administrative staff.‎

Where meals and refreshments are provided in conjunction with a business meeting, training and education program or conferences, the following limits are recommended: ‎

• CAN 50 maximum for breakfast; ‎
• CAN 75 maximum for lunch; and
• CAN 150 maximum for dinner.

Where meals and refreshments are provided as a stipend for an HCP who is travelling and eating on their own, the following limits are recommended:

• CAN 25 maximum for breakfast; ‎
• CAN 50 maximum for lunch; and
• CAN 75 maximum for dinner.

Companies may consider exceptions to the above recommended limits, where local higher cost of meals and refreshments legitimately warrants it.

Individual invitations to lunches, dinners, breakfasts, or other attention, other than those permitted as part of the educational or promotional activities or meetings cannot not be provided to HCPs.

Coffee or basic refreshments (minimum hospitality allowed), within the context of the activities that so specify the invitation, shall have a maximum limit of USD 22 per person, including tip and taxes.

Lunches and dinners, within the context of authorized activities with health professionals, will have a maximum limit of USD 78 per person, per meal, including tip and taxes.

Meals should be of a reasonable range.

Statutory Laws and Regulations

• No specific rules.

Codes of Conduct

Code of Ethics for Chinese Medical Doctors

• No specific rules.

RDPAC Code

• Meals should be moderate and reasonable, which should be interpreted as not more than RMB 300 per person per meal, with exceptions for rare occasions, which must be supported by appropriate approval and justification by the GM or GM-delegate(s) of the company. (Article 7).

AdvaMed China Code

• The meal should be incidental to the bona fide presentation of scientific, educational, or business information and provided in a manner conducive to the presentation of such information. The meal should not be part of an entertainment or recreational event. A Company may provide a meal only to HCPs who actually attend the meeting but may not provide a meal where its representative is not present. (Article VIII).

RDPAC Code

• Meals should be moderate and reasonable, which should be interpreted as not more than RMB 300 per person per meal, with exceptions for rare occasions, which must be supported by appropriate approval and justification by the GM or GM-delegate(s) of the company. (Article 7).

AdvaMed China Code

• Meals should be in a setting that is conducive to bona fide scientific, educational, or business discussions. Meals may occur at the HCP’s place of business. (Article VIII).

AdvaMed China Code

• Under no circumstances should companies provide alcohol or tobacco to HCPs. (Article X).

RTVSS: It has no specific restriction or limitation. Nonetheless, pharmaceuticals financing meals or providing meal services that exceed three (3) minimum daily wages during a six-month period to the same recipient must be reported.

The minimum daily wage for 2023 is: COP38,666 or approximately USD8.

AFIDRO'S Code of Ethics: Hospitality sponsorship may only include feeding costs of the guest, which must be moderated and reasonable, and only for the duration of the event.

Snacks and food offered during the event must be moderate, reasonable and accessory to the main objective of the event.

ANDI's Chamber of Pharmaceutical Industry Code of Ethics and Transparency: It sets the same standard as AFIDRO’S Code of Ethics.

ANDI's Chamber of Medical Devices and Health Supplies Code of Ethics: Sponsorships to attend educational events organized by third parties, including payments for meals, may not be provided directly to HCPs.

Regarding to interactions with HCP for the exchange of scientific, educational and business information, or business meetings, it is appropriate to provide modest and occasional meals.

RTVSS: The giving or payment for food and beverages that exceeds three (3) minimum daily wages during a six-month period to the same recipient must be reported.

The minimum daily wage for 2023 is: COP38,666 or approximately USD8.

So, if the meal, snack, or beverage exceeds USD24 (three daily minimum wages) its payment or delivery must be reported.

AFIDRO'S Code of Ethics: There is no value limit, just that meals value should be moderate, reasonable and accessory to the main objective of the event.

ANDI's Chamber of Pharmaceutical Industry Code of Ethics and Transparency: There is no value limit, it follows the same standard as AFIDRO’S Code of Ethics.

ANDI's Chamber of Medical Devices and Health Supplies Code of Ethics: Meals for the exchange of scientific, educational and business information between companies and HCP should be modest, occasional and shall not exceed the following values per person (including tips and taxes):

• Refreshments cannot exceed 5% of the minimal monthly wage, this is, COP58,000 or approximately USD12.
• Breakfast cannot exceed 15% of the minimal monthly wage, this is, COP174,000 or approximately USD36.
• Lunch cannot exceed 20% of the minimal monthly wage, this is, COP232,000 or approximately USD49.
• Dinner cannot exceed 25% of the minimal monthly wage, this is, COP290,000 or approximately USD60.

RTVSS: There is no limitation for the place that provides the meals, only their value.

AFIDRO'S Code of Ethics: There is no place limitation standards, just that meals value should be moderate, reasonable and accessory to the main objective of the event.

ANDI's Chamber of Pharmaceutical Industry Code of Ethics and Transparency: There are no limits on this subject, Code follows the same standard as AFIDRO’S Code of Ethics.

ANDI's Chamber of Medical Devices and Health Supplies Code of Ethics: Meals for the exchange of scientific, educational and business information between companies and HCP should be held in places that allow for scientific discussions, where professional information can be exchanged in an easy and agile way.

RTVSS: None.

AFIDRO'S Code of Ethics: None.

ANDI's Chamber of Pharmaceutical Industry Code of Ethics and Transparency: None.

ANDI's Chamber of Medical Devices and Health Supplies Code of Ethics: None.

The Ordinance: no specific provisions, see general rules above.

The Code: According to Article 11 lit. b(4) of the Code meals must be limited to refreshments and/or meals during the event.

The Ordinance: no specific provisions, see general rules above.

The Code: according to Article 11 lit. b(4) of the Code costs of meals must be of moderate value amounting to maximum amount as determined in the binding Annex C (not yet defined, 2021 version of the Code referred to a maximum amount of HRK 500,00 / person /meal (ca. EUR 66,00). In case of international events, the maximum value of meals set in the host country shall prevail.

The Ordinance: no specific provisions, see general rules above.

The Code: no specific rules, see general rules above.

The Ordinance: no specific provisions, see general rules above.

The Code: no specific rules, see general rules above.

There is no specific limitation on providing meals. However, the provided hospitality must be secondary to the main purpose of the meeting and appropriate (not out of proportion to the event).

There is no specific limitation on the maximum value for meals.

It should only include the main course, coffee/tea, soft drinks, snacks, and other refreshments to be generally considered as reasonable.

Meals may be held in venues that are appropriate and conducive to the main purpose of the meeting. Therefore, it is highly recommended to choose mid-priced establishments.

No specific rules.

The level for reasonable hospitality should always be assessed for a specific event and assessment. Dinner or similar meals can only be offered at events consisting of at least two hours of professional content - cake, fruit, coffee/tea/ soft drinks, or the like excepted. In the event of less than two hours of professional content, there would have to be an assessment of whether the hospitality provided actually amounted to a meal (ENLI, Guidance on “The Pharmaceutical Industry's Code of Practice on Promotion etc., of Medicinal Products aimed at Healthcare Professionals" (The Promotion Code), p. 76).

The following limits apply:

• DKK 450 maximum per lunch, including drinks, VAT and gratuities;
• DKK 850 maximum per dinner, including drinks, VAT and gratuities.

The maximum amount per day is DKK 1,400 (ENLI, Guidance on “The Pharmaceutical Industry's Code of Practice on Promotion etc., of Medicinal Products aimed at Healthcare Professionals" (The Promotion Code), p 78).

Directive

No specific rules.

EFPIA

No specific rules.

IFPMA

Refreshments and/or meals incidental to the main purpose of the event can only be provided:

• exclusively to participants of the event; and
• if they are moderate and reasonable as judged by local standards.

Directive

No specific rules.

EFPIA

Member Companies must not provide or offer any meal (food and beverages) to HCPs, HCOs’ members or POs’ Representatives, unless, in each case, the value of such meal does not exceed the monetary threshold set by the relevant Member Association in its National Code.

IFPMA

No specific rules.

The Finnish Medicines Act or Degree 

No specific rules 

Code of Ethics issued by Pharma Industry Finland 

No specific rules 

See the general principles on hospitality in Accommodation.

The Finnish Medicines Act or Degree 

No specific rules 

See the general principles on hospitality in Accommodation. 

Code of Ethics issued by Pharma Industry Finland 

The following limits apply:

• EUR 45 maximum per lunch per person, including VAT;
• EUR 100 maximum per dinner per person, including VAT.

The Finnish Medicines Act or Degree 

No specific rules 

Code of Ethics issued by Pharma Industry Finland 

No specific rules 

See the general principles on hospitality in Accommodation. 

The Finnish Medicines Act or Degree 

No specific rules 

Code of Ethics issued by Pharma Industry Finland 

No specific rules 

See the general principles on hospitality in Accommodation. 

• Spontaneous meals (i.e. not planned in advance) related to the HCP’s profession are allowed within the limit of €30, twice per calendar year
• Meals offered during events can be allowed, subject to compliance with the rules detailed below

The meals must be of reasonable value and strictly limited to the purpose of the event.

It must be provided for in a written contract between the company and the HCP.

Such contract must be submitted to the relevant authority/professional association for prior (i) declaration or (ii) authorization, depending on the amounts at stake (threshold: €50 per meal, €15 per snack).

Key information (including the name of the company and the HCP, the date of the contract, the amount and type of benefit granted to the HCP) must be disclosed on the French public health transparency website.

Please note that starred-restaurant and sumptuary expenses will likely be refused.

StGB

No specific rules. However, the general principles outlined above apply.

HWG

No specific rules. However, the general rules and restrictions on providing financial inducements and other gifts to HCPs may apply.

UWG

No specific rules.

FSA Code of Conduct Healthcare Professionals

Meals may be provided if and to the extent appropriate and necessary in light of the specific job-related and science-oriented event. Generally, appropriate lunch may be provided for a full day event (including catering during breaks), but no additional dinner. The type of meals, refreshment and beverages provided should clearly take a back seat and not constitute an independent incentive to visit the event. Luxurious and / or extravagant refreshments and meals are not appropriate.

StGB

No specific rules. However, the general principles outlined above apply.

HWG

No specific rules. However, the general rules and restrictions on providing financial inducements and other gifts to HCPs may apply.

UWG

No specific rules.

FSA Code of Conduct Healthcare Professionals

Generally, there is a maximum of € 60.00 per meal. Maximum of 3 meals per day (but not € 60.00 per meal if more than one is provided on a given day, rather considerably lower for two meals and max. € 60.00 for one meal). The costs and time of meals should be appropriate as regards to the actual duration of the meeting. Extravagances are not appropriate. The maximum amount of € 60.00 might be judged more generously under the specific circumstances of the individual case.

StGB

No specific rules. However, the general principles outlined above apply.

HWG

No specific rules. However, the general rules and restrictions on providing financial inducements and other gifts to HCPs may apply.

UWG

No specific rules.

FSA Code of Conduct Healthcare Professionals

Since the specific job-related and science-oriented purpose of the event should be in the foreground, generally, meals should be provided at the event venue selected according to objective criteria mentioned above. By contrast, especial locations with experiential character (e.g. Michelin-starred restaurants) will likely give the impression that the focus is on the experiential character instead of the opportunity for professional discussion.

No specific rules

EUR70 maximum per day, including VAT.

No specific rules

PBO: No specific rules.

HKAPI Code of Practice: Limited to refreshments and/or meals incidental to the main purpose of the event (para 5.3(f))

Should only be provided to participants of the event and not their guests; and if moderate and reasonable as judged by local standards. (para 5.3(f))

Code of Conduct: No specific rules.

Maximum value for meals (e.g., EUR 60) – please specify by meal (breakfast, lunch, dinner) where applicable

PBO: No specific rules.

HKAPI Code of Practice: HK$400 per attendee for breakfast or for lunch, and a maximum of HK$800 per attendee for dinner (excluding service charges/gratuity or incremental costs attributable to venue rental where necessary and identifiable).  (Appendix 2(2))

For meals provided during events taking place overseas, the value should be reasonable by local standards in the relevant country and to the extent possible at a level comparable to the amount allowable in Hong Kong.

Code of Conduct: No specific rules.

FCC and its guidelines

It is prohibited for pharmaceutical companies to provide meals to HCPs as a means of unjustifiably inducing transactions of pharmaceutical drugs.

Further, meals provided by pharmaceutical companies to HCPs must be reasonable and appropriate in light of normal business practices and not extravagant under normal social conventions.

FCC and its guidelines

The monetary limit for all kinds of meals is JPY 5,000 per person (excluding consumption tax).

FCC and its guidelines

The places where meals are provided must be reasonable and appropriate in light of normal business practices and not extravagant under normal social conventions.

The following limits apply:

• EUR45 maximum per lunch;
• EUR90 maximum per dinner.

Hospitality must always be of a reasonable level and remain incidental to the main purpose of the event.

The meals and refreshments that are offered must be subordinate to the main purpose of the meeting or manifestation. 

For instance, breaks from the substantive programme must be logical intermissions. By way of example, refreshments after an evening programme where a meal was also offered already is not permitted.

Coffee and tea breaks, lunches, drinks, and dinners should be logical interruptions to the program.

For either meetings or manifestation the meals may not exceed EUR75 per occasion.  

• Any cost for meals must either be included in the EUR500 per event / EUR1500 per year cap or the HCP may bear 50% of the cost; or
• For manifestations it must be included in the EUR75 per event / EUR375 per year cap.

Medicines New Zealand Code of Practice

Any hospitality provided by a company to HCPs must be clearly secondary to the medical education or business purpose of the company organised meeting.

Meals and beverages must be appropriate for the educational content and duration of the meeting and should not be excessive. This applies whether the company organised meeting is held in New Zealand or overseas with New Zealand HCPs.

Offering “takeaway” meals or meals intended to be eaten outside the meeting (such as “dine and dash” programmes) are prohibited.

Medicines New Zealand Code of Practice

Hospitality must not be excessive.

In general, HCPs should be satisfied that this will not lead to a perceived loss of independence.

Medicines New Zealand Code of Practice

Hospitality must be appropriate, clearly secondary to the educational content and duration of the meeting and must not be excessive.

Offering takeaway meals, or meals intended to be eaten outside the meeting, is prohibited.

There are no restrictions on the provision of alcohol.

HCPs should be satisfied that this will not lead to a perceived loss of professional independence or expectations of decency.

Updates for 2022:

Hospitality Rate A = Lunch: NOK263.

Hospitality Rate B = Dinner: NOK999.

The rates are inclusive of drinks and VAT, exclusive possible "tips".

Hospitality rate A can be applied for promotional visits.

For events and work meetings abroad, the rates in the host country apply (determined by national industry association).

Events/work meetings must include at least 45 minutes of professional content in order for hospitality rate A to be applicable.

Events/work meetings must include at least 90 minutes of professional content in order for hospitality rate B to be applicable.

Events/work meetings that include at least 5 hours of professional content can use hospitality rates A and B in combination.

At events/work meetings that include at least 5 hours of professional content, and for which participants need to arrive the evening before due to the timing of the meeting, a meal may be served the evening before the meeting for up to 50% of hospitality rate B.

Maximum value for meals (2022):

Lunch:  NOK263.

Dinner: NOK999.

Norwegian Pharma Law

No specific rules.

LMI Industry rules

No specific rules except the general extravagant or luxurius test referred to under Event venue.

A Michelin-starred restaurant would typically not be appropriate.

Serving wine and beer in moderate amounts with dinner after meetings is allowed.

Moderate amounts is normally understood as 1-2 glasses. It is not permitted to serve alcoholic aperitifs or spirits.

Alcohol must never be served in the workplace or in connection with digital events.

Polish Pharmaceutical Law

No specific rules.

INFARMA

• PLN 200 for meals offered in Poland; or
• the amount determined by the relevant local organization in the case of meals offered outside Poland; or
• the equivalent of EUR 100 in the case of no maximum amounts established locally

- inclusive of taxes

PZPPF

No specific rules.

No specific rules.

No specific rules.

The following limits apply:

• RON 150 maximum for one main meal (lunch or dinner);
• RON 35 for coffee break.

Act on medical products

No specific rules. 

AIFP Code of Conduct

Hospitality offered in the form of meals should be limited to the amount of EUR 75 per the main course (lunch/dinner), EUR 100 for an all-day meal in the Slovak Republic and the amount of EUR 100 for the main course abroad. 

ADL Code of Ethics

No specific rules. 

GENAS Code of Ethics

No specific rules.

The Code

EUR60 maximum per meal, including beverages, per person (including VAT) if the event is set in Slovenia. If the event is set abroad the monetary threshold set in the country where the event takes place shall prevail.

Refreshments should not exceed the usual meeting standards (e.g., alcoholic beverages or excessive/expensive snacks).

In addition, for events of short duration, the level of hospitality shall be reasonable. In any case, it must be ensured that there are no elements that could damage the image of the pharmaceutical industry.

No meal may be offered at the following venues:

• Sports resort hotels (e.g. with golf course, etc.);
• Theme park hotels;
• Winery hotels;
• Five-star grand luxury hotels.

Under the Ethical Rules for the Pharmaceutical Industry, the following limits apply:

• SEK300 (incl. VAT) maximum for lunch;
• SEK850 (incl. VAT) maximum for dinner.

Marketing, professional, or scientific events must be accompanied by meals.

No rules for specific meals.

Consultants that have provided certain services are entitled to compensation for costs incurred in the provision of such services, including meals. Such compensation shall be reasonable and based on the fair market value.

Hospitality concerning marketing, professional, or scientific events shall be limited to travel, meals, accommodation, and the real registration fees. Hospitality must not exceed the level that HCPs would be willing to pay the cost of themselves.

ABPI Code

Any subsistence associated with the meeting must be secondary to the nature of the meeting, and must be appropriate and not out of proportion to the occasion.

Bribery Act

As with the other elements set out herein, the Bribery Act does not specifically prohibit or mandate the nature of interactions, but applies more broadly to any advantage which is intended to induce or reward improper performance of a relevant function or activity. Care should therefore be taken to ensure that meals offered are not so lavish as to appear as such. Following the requirements set out in the ABPI Code will support this.  

ABPI Code

The cost of a meal (including drinks) provided by way of subsistence must not exceed GBP75 per person, excluding VAT and gratuities. 

The maximum of GBP75 plus VAT and gratuities is appropriate only in very limited circumstances, such as dinner at a residential meeting for senior consultants, or a dinner at a learned society conference with substantial educational content. The cost of a meal (including drinks) should normally be well below this figure. 

The maximum amount does not apply where the meeting is held outside the UK in a European country where the national association is a member of EFPIA and is thus covered by EFPIA Codes. In such circumstances the limits of the host country would apply.

Bribery Act

As above. There are no set limits under the Bribery Act, but costs should not be so high as to appear lavish.

ABPI Code

Donations in lieu of hospitality are unacceptable. If hospitality is not required at a meeting there is no obligation or right to provide some benefit of an equivalent value.

No payment may be offered or paid to individuals to compensate merely for the time spent in attending events/meetings.

Federal Law & Implementing Regulations, & Government-Issued Guidance: The laws and regulations do not specifically enumerate or define "appropriate" versus "inappropriate" standards regarding the provision of meals, but the situation in which they are offered is likely to impact the government’s perception of potential intent to induce or reward. In addition, the HHS-OIG Guidance specifically notes that companies providing benefits, including meals, in association with information or marketing presentations could potentially implicate the AKS.  The HHS-OIG Guidance states generally, with respect to entertainment, recreation, travel, meals, gifts, gratuities, and other business courtesies that the AKS should be considered and that “compliance with the PhRMA Code with respect to these arrangements should substantially reduce a manufacturer’s risk.”  68 Fed. Reg. 23,721, 23,738 (May 5, 2003). See below. HHS-OIG generally expects meals and refreshments to be reasonable and modest. Enforcement actions have cited kickbacks in the form of expensive dinners and excessive alcohol. 

State Laws & Implementing Regulations: States have varying approaches to meal limitations. For example, Vermont prohibits the provision of meals or other food items to Vermont HCPs or non-prescribing staff, unless the meals are fair market compensation for HCP services or refreshments at a convention booth.  Other states, like Massachusetts, limit the provision of modest meals for HCPs to in-office educational presentations and out-of-office speaker programs and conventions. 

Industry Codes of Conduct: The PhRMA Code permits modest, occasional meals if they are offered in the appropriate circumstances and venue. PhRMA’s Statement on Application of PhRMA Code Section 2 During Emergency Periods addresses the provision of meals in conjunction with virtual presentations to HCPs during the COVID-19 pandemic. Meals may only be provided if there is a reasonable expectation that the HCP will remain present throughout the event, and meals should continue to be limited to in-office or in-hospital settings. The AdvaMed Code provides that meals may only be provided to HCPs who attend and have a bona fide purpose for attending the meeting (e.g., no meals for entire office staff or guests).  Both the PhRMA Code and AdvaMed Code specifically warn against “dine & dash” programs offering meals without a company representative being present at the meeting.

Federal Law & Implementing Regulations, & Government-Issued Guidance: The laws and regulations do not specifically enumerate or define a maximum dollar value for meals, but the value is likely to impact the government’s perception of potential intent to induce or reward. In addition, the HHS-OIG Guidance specifically notes that companies providing benefits, including meals, in association with information or marketing presentations could potentially implicate the AKS.  The HHS-OIG Guidance states generally, with respect to entertainment, recreation, travel, meals, gifts, gratuities, and other business courtesies that the AKS should be considered and that "compliance with the PhRMA Code with respect to these arrangements should substantially reduce a manufacturer’s risk."  68 Fed. Reg. 23,721, 23,738 (May 5, 2003).  See below. HHS-OIG generally expects meals and refreshments to be reasonable and modest. Enforcement actions have cited kickbacks in the form of expensive dinners and excessive alcohol.  Federal guidance may also discuss limitations on meals for certain HCP interactions (e.g., OIG Special Fraud Alert on Speaker Programs notes a recent settlement involving instances where the average per attendee cost for food and alcohol at a speaker program exceeded $500).  

State Laws & Implementing Regulations: Some states incorporate concepts such as “modest” meals, with consideration of local standards, and gift caps which may come into play for meals depending on the circumstances.  For example, Minnesota sets an annual $50 cap, and Maine allows "modest" meals and refreshments of minimal value in certain circumstances and defines "modest" as the cost similar to that which an HCP would pay when dining at his/her own expense as judged by local standards where the event is held. Other states more generally incorporate PhRMA Code and/or AdvaMed Code standards by reference.

Industry Codes of Conduct: The PhRMA Code indicates that, in circumstances in which providing meals is otherwise appropriate under the Code, they should be modest as judged by local standards.  The AdvaMed Code also provides that permissible meals provided to HCPs must be modest and "provided in a manner conducive to the presentation of scientific, educational, or business information."

Federal Law & Implementing Regulations, & Government-Issued Guidance: The laws and regulations do not specifically enumerate or define "appropriate" versus "inappropriate" venues for meals, but the selection is likely to impact the government’s perception of potential intent to induce or reward.  In addition, the HHS-OIG Guidance specifically notes that companies providing benefits, including meals, in association with information or marketing presentations could potentially implicate the AKS.  The HHS-OIG Guidance states generally, with respect to entertainment, recreation, travel, meals, gifts, gratuities, and other business courtesies that the AKS should be considered and that "compliance with the PhRMA Code with respect to these arrangements should substantially reduce a manufacturer’s risk." 68 Fed. Reg. 23,721, 23,738 (May 5, 2003).  See below.  HHS-OIG generally expects meals and refreshments to be reasonable and modest. Enforcement actions have cited kickbacks in the form of expensive dinners and excessive alcohol. In addition to guidance more generally on appropriate venue and modest meals, advises against high-end restaurants. For example, OIG Special Fraud Alert on Speaker Programs said that suspect venues include high-end restaurants. 

State Laws & Implementing Regulations: In addition to guidance more generally on appropriate venue and modest meals, some states specifically include language mirroring the PhRMA Code in requiring that meals provided to health care providers generally must be provided in the provider's office or hospital setting. Some states more generally incorporate PhRMA Code and/or AdvaMed Code standards by reference. 

Industry Codes of Conduct: In addition to guidance more generally on appropriate venue and modest meals, the PhRMA Code states that sales representatives may provide meals in the HCP office or hospital only when provided in connection with an accompanying informational presentation and prohibits out-of-office meals by sales representatives or their immediate managers (except in connection with a speaker program). The AdvaMed Code provides that appropriate settings may include the HCP’s place of business "or an off-site space that is conducive to the discussion, such as a restaurant."