Frier Levitt was recently successful in assisting a California-based specialty pharmacy client in recovering claims pertaining to a major PBM’s error in interpreting California refill laws. Our attorneys were able to extensively review the relevant rules surrounding prescription refills, demonstrating to the PBM that the pharmacy’s prescription refills were properly authorized and documented at the time of dispensing. In response, the PBM agreed to reverse the recovery in full for such claims.
Pharmacies should be aware of their rights and protections against erroneous PBM audit findings and allegations that could have short and long-term ramifications. Though smaller amounts may not seem to be ‘worth’ disputing, the failure to do so may result in complaints to the State Board of Pharmacy or other regulatory bodies, including CMS or DEA.
Frier Levitt attorneys have extensive experience representing specialty pharmacies against abusive PBM practices. Contact us if your pharmacy is involved in a PBM audit that may implicate further adverse action if left unresolved.
