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
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
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
Frier Levitt recently helped a Connecticut-based independent pharmacy that was being audited by a major PBM by successfully challenging the audit and reducing the audit discrepancies by more than 90%. During the audit, the PBM requested a host of... Read More
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
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
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
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
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
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
