Pharmacy Benefit Managers (PBMs) routinely request that pharmacies submit credentialing and re-credentialing applications, which require pharmacies to provide complete ownership information. In addition, PBMs require that pharmacies identify any... Read More
Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Life Sciences | Pharmacy Law | Uncategorized

Pharmacy Benefit Managers (“PBMs”) regularly review network pharmacies to ensure that they are meeting terms and conditions identified in their Provider Agreements and Pharmacy Manuals. One mechanism for this review includes audits and... Read More
Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Articles | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Fertility Pharmacies | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A)

In the past week alone, Frier Levitt has seen a sudden increase in actions by pharmaceutical manufacturers against pharmacies related to the use of certain patient savings programs, such as copay coupon programs.  These programs are designed to... Read More
Articles | Chain Pharmacies | Community, Retail Pharmacies | Digital Pharmacies | Fertility Pharmacies | Integrated Delivery Network | Integrated Delivery Network and Hospital System Pharmacy | Long-Term Care Pharmacies | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A)

Frier Levitt was recently successful in assisting a New Jersey-based specialty pharmacy with the reversal of a full audit chargeback of over $100,000 plus the additional audit fee. A major PBM had conducted an extensive audit on the pharmacy and... Read More
Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Fertility Pharmacies | Long-Term Care Pharmacies | News | Recent Results | Recent Successes | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A)

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)

Pharmacy benefits manager (PBM) Caremark has now placed Trimester 1 Reports for year 2022 in the Caremark Provider Portal.  Caremark provides its summaries of Direct and Indirect Remuneration (DIR) Fees paid by participating pharmacy providers for... Read More
Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | DIR Fees | Life Sciences | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals | Pharmacy Law | Specialty Pharmacies

On June 29, 2022, the Department of Justice (“DOJ”) announced the formation of the New England Prescription Opioid (NEPO) Strike Force. This strike force will investigate and vigorously prosecute healthcare providers involved in healthcare fraud... Read More
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After a decade-long wait, the Food and Drug Administration finally issued a proposed rule in late June that would make it easier for pharmaceutical companies to switch products from prescription-only to over-the-counter status while still retaining... Read More
Articles | Chain Pharmacies | Community, Retail Pharmacies | Digital Pharmacies | Fertility Pharmacies | Integrated Delivery Network and Hospital System Pharmacy | Long-Term Care Pharmacies | News | Regulatory Compliance, including FDA, DEA and HIPAA | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A)

On May 9, 2022, the Centers for Medicare and Medicaid Services (CMS) released a Final Rule (Final Rule) entitled, “Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs.” ... Read More
All types of single and multi-specialty medical practice groups | Articles | Community Oncology Practices & Other Dispensing Physician Practices | Community, Retail Pharmacies | Digital Pharmacies | DIR Fees | Dispensing Physician Practices and Dispensing Physicians | Healthcare | Healthcare Law | Healthcare Practice Compliance | Life Sciences | Medicare and Insurance Audits | Medicare Audit Appeals | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals | Pharmaceutical Wholesalers | Physician Dispensing | Physician Dispensing | Physicians and Medical Practices of all Specialties | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A)