Effective on January 1, 2022, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) will implement the Final Rule for Medicare and Medicaid Programs. The Final Rule establishes pharmacy... Read More
Blogs & Articles | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Pharmacy Transactions | Plan Sponsor PBM Contract Services

This article examines Pharmacy Benefit Manager’s (“PBM”) “rebate walls” and the impact on the United States drug supply chain.  The Federal Trade Commission head, Commissioner Rohit Chopra, recently issued a report on PBM rebate walls,... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Plan Sponsor PBM Contract Services

As Congress has made changes to the health care system over the past 30 years, nothing has impacted consumers' lives as much as the growth of pharmacy benefit managers (PBMs). Most consumers might not think that PBMs play a large role in their... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Maximum Allowable Cost Pricing & Appeals | News & Press | Pharmacy Law | Plan Sponsor PBM Contract Services

As we reported here, Plan Sponsors have begun elevating their challenges of Pharmacy Benefit Managers’ (“PBMs”) and Managed Care Organizations’ (“MCOs”) conduct, from PBM pricing  to auditing and litigating over PBM practices such as... Read More
Blogs & Articles | Community, Retail Pharmacies | Life Sciences | Pharmacy Law | Plan Sponsor PBM Contract Services

The United States drug supply chain is dominated by three vertically integrated Pharmacy Benefit Managers (“PBMs”) that are owned under the same corporate umbrella as the largest insurance companies, specialty pharmacies and chain pharmacies. ... Read More
Blogs & Articles | Life Sciences | Pharmacy Law | Plan Sponsor PBM Contract Services

https://youtu.be/sCUAjwc-wdg Frier Levitt’s Jonathan Levitt, Esq. and Lucas Morgan, Esq. talk about PBM Audit Fees in our latest video!  Learn about what a PBM audit fee is, what plan sponsors need to know, laws that pharmacies should be aware... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Pharmacy Law | Plan Sponsor PBM Contract Services | Videos

Frier Levitt's Plan Sponsor Co-Chairs Jonathan Levitt, Esq., and Dae Lee, Pharm.D., Esq., CPBS, Author Article for BenefitsPRO on Plan sponsors losing manufacturer rebate dollars to PBMs through rebate aggregators.   Pharmacy benefit managers... Read More
Blogs & Articles | Life Sciences | News & Press | Pharmacy Law | Plan Sponsor PBM Contract Services

The “law” applicable to drug reimbursement encompasses an array of laws across 50 states, the territories, and the federal government. These laws and regulations determine what a “Plan Sponsor” (such as an insurance plan, State Medicaid... Read More
Blogs & Articles | Community, Retail Pharmacies | Life Sciences | Maximum Allowable Cost Pricing & Appeals | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals | News & Press | Pharmacy Law | Plan Sponsor PBM Contract Services

One of the most challenging issues for independent pharmacies throughout the United States is the issue of pharmacy benefit managers’ (PBMs) reimbursement practices. There are numerous ways in which PBMs dictate reimbursement to independent... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Plan Sponsor PBM Contract Services | Specialty Pharmacies