Blog

»  Posts By   2019 

Frier Levitt Successfully Reverses PBM Network Termination

Frier Levitt was recently successful in reversing a Florida pharmacy’s network termination by a major PBM. The PBM had sent a Notice of Termination alleging that the pharmacy failed to comply with terms and conditions set forth by PBM Agreement and Provider Manual by waiving copays and processing unwanted refills. Notably concerning was that the pharmacy did not receive any notice of audit prior to receiving the Notice of Termination. ...

Manufacturer ALERT: Vitamin Supplements May Contain Toxins

An Illinois man alleges that he was exposed to toxins, including arsenic, cadmium, and lead, which were in The Vitamin Shoppe's daily vitamin supplement. The complaint was filed by Harvey Mahler in the Circuit Court of Cook County but is now pending in the United States District Court for the Northern District of Illinois.  The lawsuit presents claims against the manufacturer and the distributor, The Vitamin Shoppe, indicating that the...

Quest Diagnostics and LabCorp Report Major Data Breaches Caused by a Business Associate

Quest Diagnostics (Quest) and LabCorp each reported in their respective 8-K filings with the Security and Exchange Commission that the companies had been notified by American Medical Collection Agency (AMCA), a billing collections vendor, that between August 1, 2018 and March 30, 2019 an unauthorized user had access to AMCA's system that contained information that AMCA had received from both companies. The number of affected individuals is estimated to be...

OIG Issues Fraud Alert Related to Genetic Testing Scam

The Office of the Inspector General for Health and Human Services (OIG) recently issued a Fraud Alert to the public identifying a fraud scheme involving genetic testing. To reduce fraud and abuse in federal health care programs, including Medicare and Medicaid, the OIG actively investigates potentially fraudulent schemes that are used to obtain money from these programs and, when appropriate, issues alerts that identify practices that are potentially fraudulent. This Alert...

Frier Levitt Successfully Reverses Termination from PBM Network for a New York Pharmacy

A New York Pharmacy's network termination by a major PBM for a was recently rescinded as the result of emergent intervention from Frier Levitt. The PBM was alleging discrepancies in the pharmacy's credentialing document and, although the pharmacy's principal never made any intentional misrepresentations, the PBM nevertheless terminated the pharmacy and plan sponsors sent out notices to the pharmacy's patients. Frier Levitt assisted at all stages of the dispute. Frier...