When looking to purchase a pharmacy, prospective owners must take into consideration multiple aspects of the transaction in order to ensure a successful continuation of operations post-closing. Failure to properly evaluate, structure, and execute a... Read More
The refusal to provide comparator products violates federal and state antitrust laws and the CREATES Act. Although the Supreme Court has expressed caution about imposing antitrust liability based on a monopolist’s unilateral refusal to deal, the... Read More
On March 18, 2021, the U.S. Senate confirmed Xavier Becerra, a longtime proponent of mental health parity laws, as the new Secretary of the Department of Health and Human Services (“HHS”). Becerra’s nomination was supported by Mental Health... Read More
On January 21, 2021, the U.S. Department of Health and Human Services (“HHS”) published proposed rules that would significantly modify existing regulations concerning the Health Insurance Portability and Accountability Act (“HIPAA”). The... Read More
As part of routine audits, Pharmacy Benefit Managers (“PBMs”) regularly request pharmacies to produce documents pertaining to prescription claims. Amongst the documents commonly requested are copies of prescriptions, prescription labels, and... Read More
On November 2, 2020, the Drug Enforcement Administration (DEA) published notice of a new Proposed Rule, “Suspicious Orders of Controlled Substances,” to “clarify the procedures a registrant must follow for orders received under suspicious... Read More
Frier Levitt recently assisted a New York-based independent pharmacy that was placed under temporary payment suspension by a national Pharmacy Benefit Manager (“PBM”). Notably concerning, the temporary suspension was effectuated while the... Read More
In Wisconsin, Governor Tony Evers recently signed a bipartisan bill into law aimed at regulating pharmacy benefit managers (PBMs). This law, which was unanimously passed in the Wisconsin legislature, is significant for several reasons including... Read More
Earlier this week following a three-day bench trial, the owner of, and a licensed mental health counselor at, a Tallahassee-based counseling center, were found guilty of health care fraud conspiracy, health care fraud, and aggravated identity theft.... Read More
The “law” applicable to drug reimbursement encompasses an array of laws across 50 states, the territories, and the federal government. These laws and regulations determine what a “Plan Sponsor” (such as an insurance plan, State Medicaid... Read More
