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»  Posts By   April 2019 

The Growing Trend of PBM Track-And-Trace Audits

Recently, Pharmacy Benefit Managers (PBMs) have been requesting pharmacies to provide documentation in compliance with Drug Supply Chain and Security Act (DSCSA), better known as “track-and-trace." DSCSA was enacted as part of the Drug Quality and Security Act of 2013 and outlines steps for the drug chain participants to implement a system that tracks a drug at the unit-level throughout the drug supply chain. At this juncture, the United States...

The Continued Scrutiny of Opioids: What Physicians and Pharmacists Need to Know

The war on opioids continues unabated, most recently with the Appalachian Regional Prescription Opioid Strike Force conducting another roundup. The roundup, which included the execution of search warrants, involved the charging of 60 people, including 53 medical professionals, with illegally prescribing controlled substances, which further supports the growing sentiment that the indiscriminate prescribing of opioids is the current hot-button item in medicine. The basic standard applied by authorities to individuals...

Senators Ask OIG to Investigate PBM Industry

After the Senate Finance Committee's hearing (third in a series of hearings), "Drug Pricing in America: for Change," held on April 9, 2019, Senators Chuck Grassley and Ron Wyden wrote a letter to the Department of Health and Human Services' Office of Inspector General (OIG) alerting OIG that "increasing number of reports" raise concerns about how Pharmacy Benefit Managers (PBMs) are operating. In the letter, Senators Grassley and Wyden expressed...

NJ Client ALERT: Governor Murphy Signs Bill Banning Cashless Stores in New Jersey

On March 18th, 2019, New Jersey Governor Phil Murphy signed state assembly bill No. 591 which serves to generally prohibit discrimination against consumers paying for goods or services with cash (the "Act"). The Act makes it an unlawful practice under the New Jersey consumer fraud act for a person to sell or offer for sale any goods or services at retail if the person requires the buyer to pay with...

Pharmacy ALERT: PSAO Pharmacy First Sends Notice of GER Deductions

Pharmacy Services Administrative Organization (PSAO) Pharmacy First is sending out a "Notice of GER Deductions" to pharmacies in its network advising that the pharmacy's reimbursements have been running in excess of the contracted Generic Effective Rate (GER) amount. The Notice warns the pharmacy that the monetary sum in excess of the contracted GER amount will be withheld. It is often the case that the pharmacy is without any knowledge of...
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