A new federal law has brought significant change in the design of pharmacy benefit plans, leveling the playing field between pharmacy benefit managers (“PBMs”) and their employee healthcare benefit plan (“Plan”) clients. For far too long,... Read More
Frier Levitt attorneys speak with prosecutors, Boards of Pharmacies, PBM auditors, wholesalers, and the like on a daily basis on behalf of pharmacies nationally. We regularly spot trends and report back to the industry. We are closely monitoring... Read More
Frier Levitt helped a New York pharmacy successfully appeal initial audit results in their entirety that were issued by a large PBM. Despite the pharmacy’s submission of purchase information directly from its wholesalers, the PBM alleged... Read More
Pharmacies and pharmacists (“licensees”) throughout the country are often anxious after learning that a State Board of Pharmacy (“BOP”) is seeking disciplinary action against them. The fear of challenging a BOP’s allegations, the same... Read More
Frier Levitt Partner Guillermo Beades and Jim Tudor, Director of Coding & Billing Compliance at HealthCare Compliance Network, recently had the opportunity to contribute their insights and expertise on medical payer audits to the American Health... Read More
On Friday, March 3, 2023, the Florida Senate introduced Senate Bill 1550 (“SB 1550”) which would regulate Pharmacy Benefit Managers (“PBMs”) operating in Florida. In January 2023 Governor DeSantis announced proposed legislation designed to... Read More
Frier Levitt recently assisted a New Jersey pharmacy client in successfully challenging a major Pharmacy Benefit Manager’s (“PBM”) audit findings and reversing 100% of the purported discrepancies. During the audit, the PBM asserted allegations... Read More
The healthcare and life science industries should be aware of the recent increase in False Claims Act (“FCA”) or “whistleblower” cases. In fiscal year 2022, the Department of Justice (“DOJ”) recovered $2.2 billion under the FCA. In 2021,... Read More
Regardless of the size of your pharmacy, pharmacy benefit manager (“PBM”) audits are inevitable. While these audits are promoted as a means to ensure network pharmacies operate in compliance with the terms of PBM Provider Manuals and federal and... Read More
Combatting opioid diversion remains a top priority for regulators and enforcement agencies. In that vein, there continues to be enhanced scrutiny on healthcare professionals over opioid prescriptions. As highlighted by recent Department of... Read More
