Frier Levitt attorneys speak with prosecutors, Boards of Pharmacies, PBM auditors, wholesalers, and the like on a daily basis on behalf of pharmacies nationally. We regularly spot trends and report back to the industry. We are closely monitoring... Read More
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On January 15, 2023, the Vermont Department of Financial Regulation (the “Department”) issued a report titled “Act No. 131 (2022) Report: Pharmacy Benefit Management” (the “Report”). As the title suggests, the Department was required... Read More
Antitrust Review and Compliance | Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Articles | Biotech Companies | Chain Pharmacies | Clinically Integrated Networks (CINs) | Community Oncology Practices & Other Dispensing Physician Practices | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | DIR Fees | Dispensing Physician Practices and Dispensing Physicians | Fertility Pharmacies | Hospitals and Healthcare Systems | Integrated Delivery Network | Integrated Delivery Network and Hospital System Pharmacy | Long-Term Care Pharmacies | Manufacturers | Outsourcing Facilities (503B) | PBM Qui Tam Lawsuits | Pharmaceutical Manufacturers | Pharmaceutical Wholesalers | Physician Dispensing | Plan Sponsor PBM Contract Services | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A) | Urologist | Veterinary Compounders

In an effort to gain market access for new drugs and to shift the conversation from one of “volume” to one of “value,” pharmaceutical manufacturers are increasingly offering and agreeing to alternative payment models that set the price of a... Read More
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Pending before Wyoming’s Joint Judiciary Committee is new legislation (HB 191) targeting the abusive practices of pharmacy benefit managers (“PBMs”) and granting pharmacies a private right of action to seek redress for damages caused by... Read More
Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Articles | Biotech Companies | Chain Pharmacies | Clinically Integrated Networks (CINs) | Community Oncology Practices & Other Dispensing Physician Practices | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | DIR Fees | Dispensing Physician Practices and Dispensing Physicians | Fertility Pharmacies | Home Infusion Providers | Hospitals and Healthcare Systems | Integrated Delivery Network | Integrated Delivery Network and Hospital System Pharmacy | Long-Term Care Pharmacies | Physician Dispensing | Section 340B In-House and Contract Pharmacies | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A) | Urologist

On January 30, 2023, the Biden Administration announced that the COVID-19 Public Health Emergency (“PHE”), which has been in effect since January 2020, is set to expire on May 11, 2023. Considering the impending end to the PHE, healthcare... Read More
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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
Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Articles | Biotech Companies | Chain Pharmacies | Clinically Integrated Networks (CINs) | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Fertility Pharmacies | Integrated Delivery Network and Hospital System Pharmacy | Long-Term Care Pharmacies | News | Recent Results | Recent Successes | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A) | Veterinary Compounders

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
Articles | Biotech Companies | MAC Pricing & Appeals | Manufacturers | Maximum Allowable Cost Pricing & Appeals | Pharmaceutical Manufacturers

As the Pharmacy Benefit Managers (PBMs) prepare for the end-of-year “housekeeping”, pharmacies should be aware of the PBM audit trends and arm themselves with information necessary to preempt—and strategies to outright avoid—falling victim... Read More
Antitrust Review and Compliance | Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Articles | Biotech Companies | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Fertility Pharmacies | Integrated Delivery Network and Hospital System Pharmacy | Long-Term Care Pharmacies | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A) | Uncategorized

As Pharmacy Benefit Managers (PBMs) review participation in their retail pharmacy networks, pharmacy providers find themselves at risk of termination over past audit results. We have recently seen a significant increase in a particular PBM... Read More
Antitrust Review and Compliance | Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Articles | Biotech Companies | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Fertility Pharmacies | Integrated Delivery Network | Integrated Delivery Network and Hospital System Pharmacy | Long-Term Care Pharmacies | Payor Network Access and Defense of Network Terminations | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A)