Frier Levitt Successfully Reduces PBM Audit by 90% for an Alabama-based Pharmacy

Frier Levitt worked with an Alabama-based pharmacy that was being audited by a regional Pharmacy Benefit Manager (“PBM”).  Upon completion of the audit, the PBM issued audit findings wherein it alleged various discrepancies including failure to provide medical records.  With Frier Levitt’s guidance, the pharmacy gathered the requisite documents and information necessary to refute the alleged discrepancies against the pharmacy. Frier Levitt worked closely with the pharmacy and utilized the contractual appeal process and as a result the audit findings were substantially reduced by 90%.

Contesting PBM audits and challenging adverse actions taken by a PBM against a pharmacy is critical to ensure that pharmacies are not having money improperly recouped from the pharmacy without a sufficient basis to justify the recoupment and to ensure they are not being exposed to additional liabilities or other adverse actions/consequences. In addition, taking prompt action ensures that patients are not inconvenienced and do not experience interruptions in their continuity of care.  Effectively navigating these complex proceedings can be difficult and challenging — working with experienced legal counsel can be critical to achieving favorable results.

How Frier Levitt Can Help

Regardless of the size of your pharmacy or the amount at stake, Frier Levitt is ready to assist you in successfully challenging the audit.   Our attorneys include clinicians who are prepared to take an aggressive approach to fight for your rights following a PBM audit.  If you have questions or need help with a PBM audit, contact us today to speak to an attorney.

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