Pharmacy Services Administrative Organization (PSAO) EPIC is sending out a “Notice of GER Deductions” to pharmacies in its network advising that the pharmacy’s reimbursements have been running in excess of the contracted Generic Effective Rate (GER) amount. The Notice warns the pharmacy that the monetary sum in excess of the contracted GER amount will be withheld and that EPIC will provide details regarding the deducted amounts upon requests. It is often the case that the pharmacy is without any knowledge of the contracted GER amount and/or the medications contributing to such GER amount. What’s worse, these deductions can range to be several hundred thousand dollars, drastically interrupting the pharmacy’s operations and cash flows.
Frier Levitt has extensive experience representing pharmacies in challenging the GER adjudication. If your pharmacy has received such a letter from EPIC or similar PSAO, contact Frier Levitt today to speak to an attorney.