Late last month, the United States Department of Justice announced that Walgreens Pharmacy had agreed to pay $7.9 million to settle allegations that Walgreens had violated the Federal False Claims Act. In a suit brought as a qui tam action by a... Read More
On June 13, 2012, the OIG issued a report following its review of four contractors that processed claims for test strips and/or lancets. The report concludes that the Medicare contractors improperly allowed for payment of a total of approximately... Read More
The United States Department of Health and Human Services Office for Civil Rights (OCR) has stepped up enforcement of the compliance requirements contained in the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and has begun... Read More
The OIG recently issued an Advisory Opinion Letter to an anonymous pharmacy that relates to a hot-topic Pharmacy Law Issue—Copayment Assistance. The OIG advised that it would not take any action against the pharmacy for a “proposed... Read More
A pharmacy owner recently lamented that she experienced a sudden and significant reduction in reimbursement rates for compounds dispensed to patients whose insurance coverage had not changed. The decrease in reimbursement began immediately after a... Read More
We see a significant “chatter” within our pharmacy client base regarding copay reimbursement programs. The legality of these programs and how the pharmacy may/should treat copay cards and/or coupons is at issue. The following Q & A is... Read More
Class Action is the most powerful tool in a lawyer’s arsenal to help independent pharmacies force national-scale changes in abusive PBM auditing conduct. In 2009, Frier Levitt obtained a $12+ Million class action arbitration award against one of... Read More
The Federal Trade Commission (FTC) approved the merger between Express Scripts, Inc. (ESI) and Medco Health Solutions, Inc. (Medco), two of the country’s three largest Pharmacy Benefit Managers (PBMs). What can pharmacies do to curb abusive PBM... Read More
On December 12, 2011, New York Governor Andrew Cuomo signed a bill into law a bill which bans Pharmacy Benefit Managers (“PBMs”) from mandating customers to use mail order pharmacies for prescription drugs. Known as the New York AMMO Law, the... Read More
In September of this year, the New York Attorney General recoup nearly $250,000 in restitution to resolve a Medicaid fraud case involving the misdeeds of a former pharmacist for Tops Market Pharmacy, headquartered in Williamsville, New York. One of... Read More
