Chicago ? Some U.S. drug makers are ending programs that provided free or discounted prescriptions to elderly Americans now that pharmaceutical benefits are widely available under the Medicare program – saying government rules are forcing them to back away.

Citing new federal anti-fraud memos advising drug makers to avoid providing inducements to patients to choose their drugs, companies say certain of their assistance programs could be interpreted as a kickback to win loyalty to their prescriptions.

It can be illegal to provide an inducement for something that later is billed to a government health insurance program like Medicare.

TAP Pharmaceutical Products Inc., maker of the popular heartburn drug Prevacid, which costs $4 per pill, said it is ending prescription assistance for elderly and disabled patients who are eligible for the Medicare drug benefit effective March 31.

“To ensure that we are in full compliance with applicable laws, patients who are eligible for Medicare and the prescription drug program can no longer participate in our patient assistance program,” said Katherine Stueland, spokeswoman for TAP.

But consumer groups say potentially hundreds of thousands of seniors could still face high out-of-pocket costs after Medicare drug coverage kicks in and would still need prescription assistance from drug makers. The U.S. Department of Health and Human Services, meanwhile, says its fraud alert is not designed to curtail drug assistance to seniors because companies could instead give their drugs to a third-party charity and therefore avoid a direct kickback.

It’s unclear exactly how many seniors will be affected by drug makers’ moves, but the main pharmaceutical industry trade group said more than 1.2 million Americans have benefited from a prescription assistance program that began in April, and 30 percent or more have been seniors.

In addition to seniors, such programs help the poor and uninsured pay for their drugs. Drug makers say they will continue to help those groups and in some cases are escalating their help to people without health insurance.

Despite the Medicare drug coverage that began Jan. 1, there can be significant gaps in coverage depending on which plans seniors choose, so consumer groups say the elderly and disabled could still benefit from drug companies’ programs.

For example, the standard Medicare drug benefit requires consumers to pay a $250 deductible before the program begins paying for drugs. From $250 to $2,250, eligible seniors pay 25 percent of drug costs, up to $500. Between $2,250 and $5,100 there is a gap known as the “doughnut hole” and consumers are responsible for all of those bills, up to $2,850. After $5,100, a consumer will pay 5 percent of drug charges.

“There are a lot of challenges for people who are low income,” said Lynda DeLaforgue, co-director of the consumer group Citizen Action/Illinois. “There are significant resources being put in by drug companies, and millions of consumers are benefiting from these programs. This is just a good excuse for them to get out of those programs.”

Several drug makers are voiding prescription assistance to those who have enrolled in Medicare plans. But most drug makers, such as Abbott Laboratories, Pfizer Inc. and Merck & Co., are maintaining such programs for Medicare-eligible patients who opt against enrolling in a Medicare Part D drug plan, according to the companies and the industry lobbying group, Pharmaceutical Research and Manufacturers of America (PhRMA).