Anthony Mahajan authors article for Total Pharmacy titled “Part D Participants Should Validate Audit Processes for Prescription Drug Event Data.”
Frier Levitt Partner, Anthony J. Mahajan, Esq. has authored an article in the May 10, 2021 issue of Total Pharmacy titled “Part D Participants Should Validate Audit Processes for Prescription Drug Event Data.” The premise of the article discusses a case that Mr. Mahajan reviews where a district judge in New Jersey recently permitted the relator in United States ex rel. Silver v. Omnicare Inc. to file an amended complaint alleging that a pharmacy’s submission of dispensing data to a Part D plan sponsor or PBM, and the inclusion of that data in a subsequent Prescription Drug Event (PDE) submission to CMS, may support FCA liability where the underlying prescriptions were “tainted” by a kickback scheme.
“Unlike sponsors and PBMs, pharmacies have less experience in auditing the accuracy of PDE data submissions, and often mistakenly rely on claims processors to identify discrepancies in the first instance. In short, this burgeoning and yet-to-be-defined scepter of FCA liability warrants monitoring and proactive attention.”
Read the full article here.