Pharmacies face serious PBM risks when issues that arise in audits are not properly addressed from recoupments and network terminations, to governmental investigations. Preparation and preventative measures are key to ensuring a positive audit... Read More
Florida-based pharmacies and pharmacists have reason to rejoice following the signing of historic pharmacy benefit manager (“PBM”) legislation into law in Florida. Specifically, on May 3, 2023, Governor DeSantis approved Senate Bill 1550 (“SB... Read More
In an alarming trend, a manufacturer of diabetic test strip has taken actions against pharmacies alleging that they purchased the manufacturer’s test strips (the “Test Strips”) from unauthorized distributors or wholesalers. The manufacturer... Read More
Continuing its aggressive efforts to combat fraud, waste and abuse in the health care system, the Federal government has focused on providers’ practices related to the disposing of and billing for single-use drugs and biological waste. Frier... Read More
Frier Levitt recently helped a New York based pharmacy overturn a network enrollment denial by a major Pharmacy Benefit Manager (“PBM”). The PBM rejected the pharmacy’s enrollment application due to allegations of “common association or... Read More
Congress has recently increased its scrutiny of Pharmacy Benefit Managers (“PBMs”), coinciding with a crucial policy shift by the Federal Trade Commission (“FTC”) that appears promising for independent pharmacies and other providers seeking... Read More
Three years ago, many PBMs enacted exceptions and waivers to their respective Provider Agreements and Manuals that would have otherwise limited the ability of participating pharmacies to provide services by way of mail to members during the COVID-19... Read More
On March 27, 2023, South Dakota Governor Kristi Noem signed into law HB 1135, providing South Dakota consumers and providers with a much-needed dose of transparency in prescription drug pricing. HB 1135 amends existing legislation and introduces new... Read More
The Food and Drug Administration (“FDA”) regulates and categorizes human cell and tissue products (“HCT/Ps”) based on the public health risks they pose. HCT/Ps are biological products that are used to repair, replace or regenerate human... Read More
Frier Levitt was recently successful in reversing a plan-initiated PBM network termination for NJ pharmacies that are under common ownership. Back in 2019, the PBM conducted an audit over the pharmacies on behalf of its plan client and alleged... Read More
