Regulators’ enforcement focus on patient support programs (PAPs) intensified, with DOJ and OIG scrutiny centered on compliance gaps tied to program design, intent, and profit-driven outcomes. At Access USA, legal and former enforcement officials warned that good-intent access goals do not by themselves reduce risk under the Anti-Kickback Statute. Speakers emphasized that prosecutors evaluate whether inducement is present—particularly when federal dollars may effectively subsidize costs tied to list-price increases or when internal communications and whistleblower evidence suggest a profit motive. Panelists also stressed that chronic-drug subsidy programs can raise heightened concerns. The session framed enforcement as evidence-driven and often rooted in operational details, not just public-facing program features. For sponsors and contract program operators, the message was to tighten structural controls and document the access rationale more defensibly.