A year ago, Prime Therapeutics (Prime) announced that it would no longer accept new Physician Dispensing entities into their pharmacy networks starting on or around January 29, 2018. At the time, Prime had not terminated any Dispensing Physician entities that were already participating providers in its pharmacy networks and had made overtures that their participation would remain unaffected. Many Physician Dispensing entities nevertheless braced for aggressive audits and investigations, out of concern over efforts to push them out of Prime’s pharmacy networks.
Recently, Prime has changed its position and has now begun terminating its existing, or “grandfathered” Dispensing Physicians. A number of Dispensing Physicians have received notices of termination from Prime on the sole basis that it no longer accepts any Dispensing Physicians, grandfathered or new, into its pharmacy networks.
Prime’s decision threatens the benefits of an integrated patient care model that Physicians Dispensers are able to create and in doing so, Prime could be subject to violations of Federal and State Laws.
If your physician dispensing entity has received a notice of termination or has been excluded from Prime Therapeutics’ pharmacy networks, contact Frier Levitt today to speak to an attorney.