PHARMACY ALERT: Frier Levitt Successfully Reverses PBM Network Termination for an Illinois Pharmacy
Frier Levitt successfully reverses a PBM network termination on behalf of an Illinois pharmacy. The PBM, which is wholly owned by a publicly traded company, conducted an onsite inspection of the Pharmacy and identified a number of expired drug products in the Pharmacy’s active drug inventory. Subsequently, the PBM issued a notice of termination to the Pharmacy.
After working with the Pharmacy to address the onsite inspection findings, Frier Levitt submitted an appeal response along with a Corrective Action Plan to the PBM and represented the Pharmacy in an appeal hearing. Frier Levitt emphasized, among other things, that the Pharmacy did not dispense any of the expired drug products to the patients and that the Pharmacy immediately implemented a robust Corrective Action Plan. Frier Levitt also highlighted the Pharmacy’s role as a vital healthcare provider that has been serving the community and its members, many of whom are vulnerable patient populations. Following the hearing, the PBM overturned its decision to terminate the Pharmacy from its Pharmacy Network.
Pharmacies that undergo any investigation or audit with a PBM are cautioned to take proactive efforts to resolve discrepancies as unresolved findings may lead to termination. Specifically, we urge all pharmacies to maintain an accurate and updated accounting of the pharmacy’s total inventory, including but not limited to, frequently and infrequently dispensed medications, rare drugs, and controlled substances.
How Frier Levitt Can Help