Frier Levitt Successfully Reduces PBM Audit Chargeback By $1.4M

Frier Levitt recently helped a Utah-based independent pharmacy who was facing a Fraud, Waste and Abuse audit conducted by a PBM and successfully reduced the audit chargeback from over $1.4M to a little over $800. The PBM alleged that the Pharmacy failed to maintain adequate inventory to support claims billed. Despite the Pharmacy’s exhaustive efforts to resolve the audit independently, the PBM was making it difficult to do so. Under the Firm’s guidance, the Pharmacy gathered the requisite information and our attorneys assisted in the appeals process and subsequent discussions with the PBM to successfully address the alleged inventory shortfalls.

How Frier Levitt Can Help

There is no indication that PBMs will refrain from conducting these types of Fraud, Waste and Abuse audits during the COVID-19 pandemic. Pharmacies may still be required to defend against these types of PBM audits in the weeks or months ahead. Audit discrepancies can make or break an independent pharmacy’s business. Contact Frier Levitt today to speak with an attorney.

Tagged with: , , , , , ,
Share: