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Frier Levitt Successfully Reverses Wrongful Termination of Pharmacies from PBM Networks

Frier Levitt has recently been successful in reversing wrongful terminations of pharmacies from Pharmacy Benefit Manager (PBM) networks. The PBMs agreed to reinstate the contractual terms with no interruption in service dates. PBMs perform routine audits on pharmacies which many times result in a number of discrepancy findings. If the pharmacy is unable to successfully contest these discrepancy findings, the PBM may present a notice of termination. In response to...

Termination Alert: Prime Therapeutics Terminates Pharmacies Based on +10% Compounding Cap

Pharmacies have begun receiving network termination notices from Prime Therapeutics pursuant to provider participation criteria enhancements that stipulate a 10% cap on compounding. State and Federal laws protect pharmacies against termination on these grounds and Prime's own provider agreement terms offer certain protections that the PBM has ignored in effectuating these terminations. Frier Levitt has been working with pharmacies to successfully reverse these terminations. Contact us today if you have...

Top 10 Hot Legal Topics in Specialty Pharmacy

In this video, Partner Jesse C. Dresser, Esq., discusses the Top 10 Hot Legal Topics in Specialty Pharmacy, including Specialty Pharmacy Network Admission; access to Limited Distribution Drugs; PBM and Payor audits; Pharmacy-Pharmaceutical Manufacturer Arrangements; Financial Transactions, including Private Equity investment and Mergers & Acquisitions; Hub Models; Reimbursement Rates and DIR Fees; Accreditation Requirements; Government Investigations; and the 340B Drug Discount Program. If you have questions regarding your Specialty Pharmacy, contact...

HIPAA Sentencing Results in Home Confinement and Probation

Several pharmaceutical district sales managers were fined and sentenced to probation, home confinement, or a combination of the three, for violations of the Health Insurance Portability and Accountability Act (HIPAA). One district manager was charged with filling out prescription prior authorizations on behalf of physicians in an effort to increase sales numbers, and instructing his representatives to do the same. The district manager was also said to have ignored a...

Importance of Proper Pain Management Evidenced by Increasing Hospitalizations for Opioid Poisonings

A recent study reported by the Journal of the American Medical Association (JAMA) has indicated that a parallel relationship exists between recent trends in opioid prescribing practices and hospitalization for opioid poisonings in children and adolescents. The study, released on October 31, 2016, concludes that, during the course of sixteen years, hospitalizations attributed to opioid poisonings in children and adolescents, or more generally, the pediatric population, have risen nearly two-fold....