When looking to purchase a pharmacy, prospective owners must take into consideration multiple aspects of the transaction in order to ensure a successful continuation of operations post-closing. Failure to properly evaluate, structure, and execute a... Read More
Blogs & Articles | Community, Retail Pharmacies | Life Sciences | News & Press | Pharmacy Law

As part of routine audits, Pharmacy Benefit Managers (“PBMs”) regularly request pharmacies to produce documents pertaining to prescription claims. Amongst the documents commonly requested are copies of prescriptions, prescription labels, and... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law

Frier Levitt recently assisted a New York-based independent pharmacy that was placed under temporary payment suspension by a national Pharmacy Benefit Manager (“PBM”).  Notably concerning, the temporary suspension was effectuated while the... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Pharmacy Law | Recent Results | Recent Successes

In Wisconsin, Governor Tony Evers recently signed a bipartisan bill into law aimed at regulating pharmacy benefit managers (PBMs). This law, which was unanimously passed in the Wisconsin legislature, is significant for several reasons including... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | DIR Fees | Life Sciences | Pharmacy Law

The “law” applicable to drug reimbursement encompasses an array of laws across 50 states, the territories, and the federal government. These laws and regulations determine what a “Plan Sponsor” (such as an insurance plan, State Medicaid... Read More
Blogs & Articles | Community, Retail Pharmacies | Life Sciences | Maximum Allowable Cost Pricing & Appeals | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals | News & Press | Pharmacy Law | Plan Sponsor PBM Contract Services

Throughout the country, several states have engaged in ongoing efforts to enact or enhance state laws aimed at regulating pharmacy benefit managers (PBMs) and certain PBM practices, including audit and reimbursement practices, causing economic harm... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Regulatory Compliance, including FDA, DEA and HIPAA

Frier Levitt was recently successful in reversing a Midwest pharmacy’s enrollment application denial by a major Pharmacy Benefit Manager (“PBM”). The PBM denied the pharmacy’s enrollment application alleging that the pharmacy was previously... Read More
Blogs & Articles | Community, Retail Pharmacies | Life Sciences | Payor Network Access and Defense of Network Terminations | Pharmacy Law | Recent Results | Recent Successes

In a recent trend, pharmacies have begun receiving notices of termination not for billing errors or audit findings, but for claims inactivity. Specifically, several Pharmacy Benefit Managers, or PBMs, have been terminating pharmacies solely because... Read More
Blogs & Articles | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Payor Network Access and Defense of Network Terminations | Pharmacy Law | Specialty Pharmacies