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2019 Industry Outlook: What State Pharmacy Associations and Pharmacy Stakeholders Need to Know

With the November elections looming, the policy environment for pharmacy issues hangs in the balance. Who will control the halls of Congress as well as the state legislature will be key in determining the pace of pharmacy legislation. Over the last several months we have seen several positive developments for pharmacy, including clawback legislation; media pressure on PBM transparency; and other industry groups, such as the National Council of Insurance...

How Pharmacies Can Take Action Against GER Deductions Regardless of Amount

Epic Pharmacy Network, Inc. (Epic) has sent demands to network pharmacies notifying its members that it will withhold future payments because of a Generic Effective Rate (GER) adjustment. These notices are being sent to network pharmacies regardless of size, and in amounts as large as more than $5 Million, but sometimes in amounts less than $20,000. Depending on the size of a pharmacy, $20,000 withheld from a pharmacy can be...

What Pharmacies Need to Know About the “Know the Lowest Price Act” and the “Patients’ Right to Know Drug Prices Act”

Two recently enacted federal laws important to pharmacies, the "Know the Lowest Price Act" and the "Patients' Right to Know Drug Prices Act" were recently signed into law. The laws are designed to remove vagueness in pharmaceutical pricing and to eliminate gag clauses in provider agreements between pharmacy benefit managers (PBMs) and pharmacies. Such gag clauses would prevent a pharmacist from disclosing to the patient that the copayment exceeded the cash price of...

Florida Attorney General Brings Action Against CVS and Walgreens for Role in Opioid Crisis

Florida is suing CVS and Walgreens for allegedly contributing to the opioid crisis. CVS and Walgreens have been added as defendants, among manufacturers and distributors, in a lawsuit brought by Florida Attorney General. Apart from the manufacturers, the lawsuit alleges that CVS and Walgreens have violated their duties under state law not only in their capacity as distributor but also dispensing pharmacies. The suit further alleges that CVS and Walgreens...

PHARMACY ALERT: Pharmacy Obtains TRO Against PSAO Preventing GER Withholding

Epic Pharmacy Network, Inc. (Epic) was ordered today to turnover any funds that it has already withheld and refrain from withholding further payment to a pharmacy in its network as a result of a Generic Effective Rate (GER) adjustment once a security bond is in place by the moving pharmacy.  Pharmacy Services Administrative Organizations (PSAOs) recently sent out "Notice of GER Deductions" to pharmacies in its network advising that the...