Frier Levitt Successfully Reverses PBM Payment Suspension

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 issuing the audit results. In fact, this type of conduct has become a troubling audit trend among major PBMs throughout the country. Frier Levitt immediately intervened and submitted a thorough appeal to the PBM. In addition, Frier Levitt created a dialogue through its established communication channels to lift the payment suspension.

Contesting PBM audits and challenging adverse actions such as payment suspension or adjudication suspension taken by a PBM against a pharmacy is critical to ensure that pharmacies are not having money improperly recouped from the pharmacy without a sufficient basis to justify the recoupment and to ensure they are not being exposed to additional liabilities or other adverse actions/consequences. In addition, taking prompt action ensures that patients are not inconvenienced and do not experience interruptions in their continuity of care. Effectively navigating these complex proceedings can be difficult and challenging — working with experienced legal counsel can be critical to achieving favorable results.

How Frier Levitt Can Help

Regardless of the size of your pharmacy or the amount at stake, Frier Levitt is ready to assist you in successfully challenging the audit.  Our attorneys include clinicians who are prepared to take an aggressive approach to fight for your rights following a PBM audit.  If you have questions or need help with a PBM audit, contact Frier Levitt today to speak to an attorney.

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