On January 12, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed new rule (the “Rule”) which, among other things, may fundamentally change controversial Direct and Indirect Remuneration (“DIR”) fees about... Read More
Blogs & Articles | Community, Retail Pharmacies | Digital Pharmacies | DIR Fees | Life Sciences | Pharmacy Law | Plan Sponsor PBM Contract Services

Independent pharmacies in Texas have significant protections from unfair practices by Pharmacy Benefit Managers (PBMs) in the form of HB 1919 and HB 1763. As previously discussed by Frier Levitt, HB 1763 provides Texas pharmacies with safeguards... Read More
Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Blogs & Articles | DIR Fees | Life Sciences | Pharmacy Law | Plan Sponsor PBM Contract Services

On December 31, 2021, Governor Hochul signed S. 3762/A. 1396 into law, one of the most comprehensive Pharmacy Benefit Manager (PBM) laws in the country. Frier Levitt previously reported on this bill as part of a suite of bills passed by the... Read More
Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | MAC Pricing & Appeals | Pharmacy Law | Pharmacy Transactions | Plan Sponsor PBM Contract Services

Pharmacy Benefit Managers (“PBMs”) are third party companies that contract with Plans/Plan Sponsors including self-funded employers and government entities to administer and manage prescription drug benefits.  In doing so, PBMs maintain network... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Life Sciences | Pharmacy Law | Plan Sponsor PBM Contract Services

The New York Legislature recently passed legislation which it has now sent to the Governor, Kathy Hochul, for signature. If signed, the “Pharmacy Rescue Package” will provide new opportunities for NY-based pharmacies and will provide much-needed... Read More
Blogs & Articles | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Life Sciences | Long-Term Care Pharmacies | MAC Pricing & Appeals | News & Press | Pharmacy Law | Plan Sponsor PBM Contract Services

“Even if there's contract language in place to prohibit this from happening, we see the same self-serving tactics,” In a recent article in Employee Benefit News called, “An attorney shares the warning signs of 'self-serving' PBMs ” Frier... Read More
Chain Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | News & Press | Pharmacy Law | Plan Sponsor PBM Contract Services

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