In a recent trend, the Blue Cross and Blue Shield Federal Employee Program (“FEP”), whose pharmacy benefits are administered by CVS Caremark, has been seeking an increasing amount of terminations of network pharmacy providers. Specifically, the... Read More
Frier Levitt successfully reverses a PBM network termination on behalf of an Illinois pharmacy. The PBM, which is wholly owned by a publicly traded company, conducted an onsite inspection of the Pharmacy and identified a number of expired drug... Read More
Pharmacies often undergo changes to their businesses and operations, primarily to adapt to the changing landscape of providing pharmacy services. These changes are the natural evolution of a business over time. However, in undergoing these... Read More
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
Frier Levitt recently filed an emergent application for injunctive relief in an arbitration filed on behalf of commonly owned pharmacy clients facing termination by a PBM following an audit of one of the commonly owned pharmacies. The PBM sought to... Read More
Frier Levitt recently commenced an emergency arbitration against a PBM that had scheduled a termination against a pharmacy client. The PBM had subjected the pharmacy to an audit and had terminated the pharmacy based upon the results of the audit.... Read More
Prime Therapeutics has announced that it will no longer accept Dispensing Physician entities into its pharmacy network starting January 29, 2018. The PBM will begin blocking PSAOs from adding physician dispensers. We also anticipate that Prime... Read More
With the potential of losing Anthem as its largest single customer, Express Scripts (ESRX) has created multiple tactics to terminate network independent pharmacies in an effort to drive prescription volume to their own mail order and Specialty... Read More
Frier Levitt has recently been successful in reversing wrongful terminations of pharmacies from Pharmacy Benefit Manager (PBM) networks. The PBMs agreed to reinstate the contractual terms with no interruption in service dates. PBMs perform routine... Read More
Pharmacies have begun receiving network termination notices from Prime Therapeutics pursuant to provider participation criteria enhancements that stipulate a 10% cap on compounding. State and Federal laws protect pharmacies against termination on... Read More