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
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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)

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
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Pharmacy benefit managers (PBMs) regularly conduct audits on pharmacies to review their performance in relation to the PBM’s terms and conditions. There are several different types of compliance audits that PBMs may initiate, such as desktop,... Read More
Antitrust Review and Compliance | Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Articles | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Fertility Pharmacies | Life Sciences | Long-Term Care Pharmacies | News | Pharmacy Law | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A)

The New York Department of Health (NYDOH) has promulgated enrollment requirements for pharmacies seeking to participate in the Medicaid program which are unrelated to many of the actual operations of pharmacies within the state of New York.... Read More
Articles | Chain Pharmacies | Community, Retail Pharmacies | Digital Pharmacies | Fertility Pharmacies | Life Sciences | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals | Pharmacy Law | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A)

Maryland was the first state in the United States to enact infertility insurance legislation and was the third state that covered fertility preservation prior to cancer treatment. Recently, on January 1, 2021, Maryland’s fertility laws expanding... Read More
Articles | Fertility Pharmacies | Life Sciences | Pharmacy Law