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»  Posts By   February 2018 

Frier Levitt Saves Two Pharmacies a Combined Total of $8MM

Frier Levitt recently assisted an Arizona-based pharmacy where the PBM began withholding well over $2.4 million before any audit results were issued. Upon release of the initial audit results, the PBM alleged (1) prescriber denial; (2) inventory shortfall; (3) unlicensed mailing; and (4) failure to collect copayment. As such, the PBM attempted to recoup a total amount of over $4 million. After submitting an appeal addressing each allegation as well...

CMS Reviving Qualified Medicare Beneficiary Initiative to Curb Illegal Medicare Billing Practices

The Center for Medicare and Medicaid Services (CMS) is restarting an initiative designed to prevent providers from illegally billing certain Medicare beneficiaries. Federal law prohibits Medicare providers and suppliers from directly billing an individual enrolled in the Qualified Medicare Beneficiary (QMB) program for Medicare Part A and Part B.    The QMB program is a State Medicaid benefit that assists low-income Medicare beneficiaries with Medicare Part A and Part B premiums...

Middle District of Florida Vacates $350 Million Dollar False Claims Act Judgment

A new opinion out of the Middle District of Florida illustrates a growing judicial trend that follows on the heels of the Supreme Court's landmark False Claims Act (FCA) decision in Universal Health Services, Inc. V. Escobar, 136 S.Ct. 1989 (2016), in which courts demand that relators demonstrate "meaningful and competent proof that the federal or the state government, if either or both had known of the disputed practices [alleged...

Frier Levitt Saves Pharmacy Over $12.6 Million in Lawsuit with Drug Manufacturer

Frier Levitt recently defended a pharmacy in a lawsuit filed by a prominent drug manufacturer alleging that the pharmacy had failed to pay for more than $14.6 million of drug product that the pharmacy had purchased. After reviewing the contract documents between the parties, Frier Levitt developed a strategy to not only establish that the pharmacy was entitled to numerous credits to offset the pharmacy's drug purchases, but also to...

Congressional Subcommittee on Health Holds Hearing Examining the FDA’s Authority in the Implementation of the Compounding Quality Act

The United States House of Representatives' Subcommittee on Health recently held a hearing examining the FDA's ever-expanding role in ensuring the enforcement of the Compounding Quality Act. Against the backdrop of a fatal meningitis outbreak caused by a compounding pharmacy in Massachusetts which infected over 750 patients in 2012, Chairman Greg Walden (R-OR) emphasized that, with respect to 503B outsourcing facilities, the FDA "must ensure that outsourcing facilities do not...