Pharmacy Benefit Managers (“PBMs”) continue to scrutinize pharmacies for prescription claims submitted during the coronavirus outbreak (“COVID-19”).  Importantly, many PBMs, payors, and governmental bodies including the Center for Medicare... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | State Board of Pharmacy Hearings and Professional Discipline

On October 5, 2021, the U.S. Department of Health and Human Services, Office of the Inspector General (“OIG”), published an Advisory Opinion (AO# 21-14) regarding a proposal to extend an existing discount program for chiropractic patients to... Read More
All types of single and multi-specialty medical practice groups | Blogs & Articles | Healthcare | Healthcare Law | Healthcare Practice Compliance | Medicare and Insurance Audits | Physicians and Medical Practices of all Specialties | White Collar Defense and Government Investigation

In yet another high-profile legal action, health insurance giant, Humana, has demonstrated its appetite to go after pharmaceutical manufacturers, supporting hubs and specialty pharmacies involved in patient assistance programs.  This past week,... Read More
Blogs & Articles | Life Sciences | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals | Pharmaceutical Manufacturers | Pharmacy Law | Specialty Pharmacies

As the cost of health care continues to rise, the presence and use of prescription discount cards has increased as well. Prescription discount cards – such as GoodRx or SingleCare – purport to offer patients access to various forms of discounts... Read More
Blogs & Articles | Chain Pharmacies | Community, Retail Pharmacies | Drug and Device Advertising, Marketing & Promotion Legal Review | Life Sciences | Pharmacy Law | Specialty Pharmacies

Frier Levitt attorneys Jonathan Levitt, Esq. ,  Dae Y. Lee, Pharm.D., Esq., CPBS,  Jesse C, Dresser, Esq. and Andreas Stargard, Esq. discuss how PBM “rebate walls” impact drug spending, patient care and competition in a recent issue of... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | News & Press | Pharmacy Law

"With the world that we're living in with COVID, vaccine mandates... back with social distancing and those mandates, it is a lot to take into consideration and it does present issues for people, practices, employers on how to maintain the proper... Read More
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The pandemic exposed, among other things, some of the shortcomings facing long-term care facilities. Being well-aware of the persistent issues long-term care facilities have with resources, the federal government nevertheless pushed for... Read More
Blogs & Articles | Healthcare | Healthcare Law | Healthcare Practice Compliance | Palliative Care, Hospice Care and Home Care | Skilled Nursing Facilities and Long-Term | Value Based Care

Earlier this summer, the U.S. Food and Drug Administration (“FDA”) issued a notice, as required by federal law, that describes the agency’s intent to conduct research examining “how firms communicate about prescription drugs from the... Read More
All types of single and multi-specialty medical practice groups | Blogs & Articles | Dispensing Physician Practices and Dispensing Physicians | Healthcare | Healthcare Law | Physician Dispensing

The revocation of enrollment in the Medicare program is an ever-present threat for providers and/or suppliers (“health care providers”). Federal regulations allow the Centers for Medicare & Medicaid Services (“CMS”) to revoke the... Read More
All types of single and multi-specialty medical practice groups | Blogs & Articles | Healthcare | Healthcare Law | Medicare and Insurance Audits | Physicians and Medical Practices of all Specialties | Professional Board Actions

To gain admission to a Pharmacy Benefit Manager ("PBM") pharmacy network, long-term care (LTC) pharmacies are expected to undergo a credentialing process. Generally, the credentialing process for an LTC pharmacy is similar to that of a retail... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Life Sciences | Long-Term Care Pharmacies | Payor Network Access and Defense of Network Terminations | Pharmacy Law