Frier Levitt recently assisted a California-based independent pharmacy that faced an audit from a major pharmacy benefit manager (“PBM”) by successfully challenging the audit findings and reducing the audit discrepancies by $159,438.46.  During... Read More
Defending Pharmacies in PBM Audits | News | Pharmacy Law | Plan Sponsor PBM Contract Services | Recent Results

Frier Levitt recently helped a Florida based pharmacy reverse a purported network termination by a major PBM.  The PBM had sent a Notice of Termination alleging that the pharmacy would be terminated due to inventory shortages identified during a... Read More
Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Recent Results

Frier Levitt was recently successful in reversing a New Jersey pharmacy’s network termination by a major PBM.  The PBM had sent Notices of Termination alleging that the pharmacy failed to comply with terms and conditions of the PBM Provider... Read More
Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Recent Results

Frier Levitt attorneys recently assisted a New Jersey-based specialty pharmacy which was audited by a large health plan and its PBM. The audit resulted in close to $100,000 for various audit discrepancies. Frier Levitt successfully argued the... Read More
Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Recent Results

Frier Levitt successfully reversed network enrollment denial by a national Pharmacy Benefit Manager (“PBM”) against a Georgia-based pharmacy.  The PBM conducted a desktop audit along with invoice reconciliation.  While the PBM did not find... Read More
Articles & Publications | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Recent Results

As PBMs review pharmacies’ participation in their retail pharmacy networks, pharmacy providers may find themselves at risk for termination. Recently, Frier Levitt assisted a New York-based retail pharmacy from termination where the PBM alleged... Read More
Articles & Publications | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Recent Results

Frier Levitt successfully reversed network enrollment denial by a national Pharmacy Benefit Manager (“PBM”) against a Dispensing Physician Practice (“Practice”).  The PBM denied the Practice’s enrollment application because the Practice... Read More
Articles & Publications | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Dispensing Physician Practices and Dispensing Physicians | Life Sciences | Pharmacy Law | Recent Results | Recent Successes

Physician groups contracting with government-regulated health plans such as Medicare-Advantage Organizations, Medicaid Managed Care Organizations, or ACA Marketplace Individual/Small Group Issuers often enter into capitated payment models with... Read More
Articles & Publications | Healthcare | Healthcare Law | Healthcare Litigation | Medicare and Insurance Audits | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals | Recent Results | Recent Successes | Value Based Care | Value Based Care

Frier Levitt successfully lifted a payment suspension imposed by a major Pharmacy Benefit Manager ("PBM") upon an independent pharmacy based in New York. The PBM effectuated the payment suspension shortly after conducting an audit but prior to... Read More
Articles & Publications | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Recent Results | Recent Successes | Specialty Pharmacies