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It is Time to Rethink Hospital-Physician Relationships

According to the AMA, employed physicians now outnumber private practice physicians for the first time. Does this mean private practice physicians will eventually be the rare exception rather than the rule? Is there still a significant role for physician-owned private practices? Relatedly, as hospitals consolidate to fight off the accelerating trend towards outpatient care, which is increasingly being controlled by health insurers (e.g., Optum, which directly or indirectly employs tens-of-thousands...

Pharmacy ALERT: CVS Caremark Releases Dispensing Limitations to be Effective January 2020

Over the past year, CVS Caremark began taking a series of actions against pharmacies who were dispensing "aberrant quantities" of medications within a particular therapeutic category. Despite never defining "aberrant quantities," CVS Caremark continued to place pharmacies whose dispensing practices were flagged for this reason under adjudication and payment suspension and/or subjected them to a Mail Order Addendum for being a "non-standard retail pharmacy." According to CVS Caremark, pharmacies that...

Plan Sponsor ALERT: Ohio Continues Its Fight Against Abusive PBM Practices

The State of Ohio has become one of the many states that have fallen victim to PBMs' abusive revenue tactics, as detailed in an audit report finding that the state's PBMs — OptumRx and Caremark — charged the state a spread of 31% on generic drugs. As a result, the state was charged $224 million, at the expense of the taxpayers, more than what these PBMs paid pharmacy providers in...

Frier Levitt Successfully Defends Three Physicians Facing Board Matters

Frier Levitt successfully represented three physicians facing actions before the Board of Medical Examiners. In one matter, a physician faced patient abandonment allegation when the patient complained about post-care prescribing practices. After preparing a thorough narrative response that detailed a physician's duties to a patient and the appropriateness of the prescribing and actions, the Board closed the matter to be kept in its confidential files. In another matter, a physician...

DEA Announces Plans to Permit Prescriptions of Controlled Substances via Telehealth

The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 prohibits providers from prescribing or dispensing controlled substances in the absence of a valid in-person encounter, with limited exceptions. One such exception permits a practitioner who has obtained "special registration" to prescribe a controlled substance for a legitimate medical purpose in the usual course of professional practice as a result of a telemedicine encounter that permits the prescriber to obtain...