Navigating Complex PBM and Regulatory Relationships
Pharmacy Services Administrative Organizations (PSAOs) play a critical role in supporting independent and specialized pharmacies in an increasingly complex PBM and regulatory landscape. But as new laws and federal reforms reshape pharmacy operations, PSAOs must stay ahead of evolving compliance requirements and reimbursement models.
Frier Levitt’s Healthcare and Life Sciences attorneys counsel PSAOs nationwide, helping them stay compliant, strengthen PBM relationships, and protect member pharmacies from financial and regulatory risk.
Our attorneys provide comprehensive counsel to PSAOs on all aspects of contracting, compliance, and dispute resolution. We combine deep regulatory insight with a practical understanding of the pharmacy marketplace to deliver real-world solutions that drive business success.
Frier Levitt assists PSAOs in negotiating, drafting, and renewing PBM and member pharmacy agreements that protect business interests and ensure compliance with state and federal law.
We help clients:
- Negotiate reimbursement and network terms that reflect true market value
- Fairly enforce Brand and Generic Effective Rate (BER/GER) provisions
- Advocate for positions that strengthen independent pharmacy interests
- Anticipate future drug pricing and reimbursement shifts
Understanding and validating effective rates agreements and reconciliation is critical for PSAOs. Our attorneys help:
- Analyze and reconcile BER and GER calculations
- Engage directly with PSAO and PBMs to ensure compliance with effective rate agreements and applicable state laws
- Identify discrepancies in PBM reimbursement practices
- Recover underpayments and improve financial transparency
- Develop internal compliance procedures for ongoing PBM rate audits
State PSAO laws and federal initiatives are rapidly changing. Frier Levitt helps clients understand what laws apply, how to remain compliant, and how to adapt operations to minimize risk.
We advise on:
- State PSAO registration and reporting laws
- Federal reforms under the Inflation Reduction Act (IRA)
- Fair dealing, transparency, and data-sharing obligations
- Ongoing monitoring of new pharmacy and PBM-related legislation
When disputes or investigations arise, Frier Levitt provides strategic, confidential, and experienced representation.
We defend PSAOs facing:
- PBM disputes over reimbursement or data disclosure
- Subpoenas or Civil Investigative Demands (CIDs) from state or federal agencies
- Requests for confidential contracts or reimbursement information
- Investigations by Attorneys General or the U.S. Department of Justice
Our team ensures prompt, compliant responses that protect your organization and its members.
Why PSAOs Choose Frier Levitt
For 25 years, Frier Levitt has represented pharmacies, PSAOs, and other stakeholders across the country. We understand the operational, regulatory, and business challenges you face and we deliver actionable, defensible strategies that work.
Our experience includes:
- Resolving PBM disputes while preserving business relationships and confidentiality
- Navigating complex state PSAO compliance requirements
- Securing fair PBM contract terms and rates
- Supporting PSAOs in responding to government inquiries
How Frier Levitt Can Help
Frier Levitt provides strategic, industry-focused legal counsel tailored to your needs. Contact our team today to learn how we can help you.