Many pharmacies are faced with PBM audits resulting in final audit finding recoupments which can range from very large to very small dollar amounts. Many times, when the recoupment is smaller in sum, pharmacies may be inclined to forgo contesting... Read More
Articles | Chain Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Life Sciences | Payor Network Access and Defense of Network Terminations | Pharmacy Law | Specialty Pharmacies

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
Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Payor Network Access and Defense of Network Terminations | Pharmacy Law

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
Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Payor Network Access and Defense of Network Terminations | Pharmacy Law | Recent Results

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
Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Payor Network Access and Defense of Network Terminations | Recent Results

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
Articles | Defending Pharmacies in PBM Audits | Life Sciences | Payor Network Access and Defense of Network Terminations | Pharmacy Law | Recent Results | Specialty Pharmacies

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
Defending Pharmacies in PBM Audits | Payor Network Access and Defense of Network Terminations | Pharmacy Law | Recent Successes

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
Defending Pharmacies in PBM Audits | Payor Network Access and Defense of Network Terminations | Pharmacy Law | Recent Successes

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
Payor Network Access and Defense of Network Terminations | Pharmacy Law | Physician Dispensing

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
Payor Network Access and Defense of Network Terminations | Pharmacy Law | Recent Successes