Earlier this month, the Centers for Medicare and Medicaid (“CMS”) released a Memorandum overviewing next steps in the federal government’s implementation of the Medicare Drug Price Negotiation Program. Though CMS has only just “set the... Read More
State Boards of Pharmacy (“BOPs”) throughout the country are empowered through various laws, rules, and regulations governing administrative agencies, like BOPs, to handle issues with the licensees they regulate, including pharmacies and... Read More
Frier Levitt successfully assisted a Georgia-based pharmacy in securing reimbursement exceeding $1.2 million due and owed to the pharmacy from a major Pharmacy Benefit Manager (“PBM”). The PBM conducted multiple audits of the pharmacy including... Read More
With the start of 2023, an amendment to Tennessee Legislation requiring that Pharmacy Benefit Managers (“PBMs”) reimburse Tennessee Pharmacies at least the actual cost of the drug, or align with Tennessee Medicaid reimbursement rates, has taken... Read More
On Thursday, January 12, 2023, Governor Ron DeSantis announced a legislative proposal to regulate “unchecked” Pharmacy Benefit Managers (“PBMs”) operating in Florida. According to Governor DeSantis, the proposed legislation is designed to... Read More
Recently, the United States filed a Notice of Settlement in the Middle District of Florida seeking to resolve its allegations that a pharmacy and its owner violated the False Claims Act. Notably, this matter was originally filed as qui tam... Read More
In its campaign against the corruption of medical decision making and illegal kickbacks, the Department of Justice (“DOJ”) has increasingly come to rely upon two pieces of legislation together with the Federal Anti-Kickback Statute (“AKS”):... Read More
Drug manufacturers and patients are being negatively impacted by the increasing use of insurer copay accumulator and maximizer programs. These programs prevent manufacturer assistance, such as co-pay coupons, from being applied towards a patient's... Read More
State Boards of Pharmacy (“BOPs”) throughout the country rely on various types of proceedings, both formal and informal, to handle legal issues with licensees (pharmacies, pharmacists, etc.) conducting business in their state. Oftentimes, less... Read More
On August 3, 2022, an Illinois federal jury returned a verdict ordering Eli Lilly & Co. (“Eli Lilly”) to pay $61 million for violations of the Federal False Claims Act (“FCA”) and adjacent state FCA laws. According to a qui tam lawsuit... Read More
