Frier Levitt successfully saved over $1.6 Million for an independent pharmacy located in Texas against a desktop-audit conducted by a major Pharmacy Benefit Manager (PBM). The PBM claimed several different discrepancies, including inventory shortfalls, missing prescriptions, and failure to collect copays. The total amount of chargeback based on the alleged discrepancies was approximately $1.9 Million. Attorney Dae Y. Lee, Pharm.D., Esq., CPBS, conducted an extensive review of the alleged discrepancies and submitted an appeal response along with the additional documentation, which ultimately reduced the total discrepant amount to only $300,000.
Pharmacies are facing heightened scrutiny by largely unregulated PBMs in the form of unreasonable audits, recoupment, and termination. Frier Levitt is well versed in the terms of the various PBM Manuals and Provider Agreements as well as state audit laws which set forth the parameters for pharmacy payment and audits and routinely works with pharmacies to protect their rights when unfairly targeted by PBMs. Contact Frier Levitt today to speak with an attorney to help you fight your audit.