Frier Levitt Co-Founder Jonathan Levitt, Partner Jesse Dresser and pharmacist-attorney Dae Y. Lee recently authored an article for Managed Healthcare Executive on "Why Timing Matters When It Comes to PBM Contracting."  Timing plays a... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Plan Sponsor PBM Contract Services

Frier Levitt successfully reversed a five year wait for readmission for an independent pharmacy into one of the largest Pharmacy Benefit Managers (“PBM”) pharmacy networks.  More specifically, the pharmacy was terminated by the PBM in 2017 for... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Life Sciences | Payor Network Access and Defense of Network Terminations | Pharmacy Law | Recent Results | Specialty Pharmacies

Pharmacy Benefit Managers (“PBMs”) have developed a perverse technique to incentivize pharmacies to dispense more expensive brands, at the expense of Plan Sponsors and patients.  Plan Sponsors seek to reduce their drug spend by encouraging the... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Pharmacy Law | Plan Sponsor PBM Contract Services

In September 2018, New Jersey Governor Phil Murphy announced that the State of New Jersey awarded the PBM contract to OptumRx and agreed to pay OptumRx $6.7 billion over three years to manage and administer pharmacy benefits for the State. Under New... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Pharmacy Law | Plan Sponsor PBM Contract Services

PBMs market themselves as “transparent” and purport to “pass through” all rebates to Plan Sponsors. However, recent litigation has brought that into question. We have seen alarming instances where PBMs secretly use little-known Rebate... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Pharmacy Law | Plan Sponsor PBM Contract Services

PBM audits often follow certain trends which vary and evolve. One potentially emerging trend Frier Levitt has observed is that pharmacies who are undergoing audits with certain PBMs, namely OptumRx, are being asked to provide an actual copy of the... Read More
Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Specialty Pharmacies

One of the greatest issues facing independent pharmacies throughout the United States is the issue of reimbursement from pharmacy benefit managers (PBMs). There are numerous ways in which PBMs dictate reimbursement to independent pharmacies which... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Maximum Allowable Cost Pricing & Appeals | Pharmacy Law