Frier Levitt successfully reversed network enrollment denial by a national Pharmacy Benefit Manager (“PBM”) against a Dispensing Physician Practice (“Practice”). The PBM denied the Practice’s enrollment application because the Practice... Read More
Frier Levitt worked with an Alabama-based pharmacy that was being audited by a regional Pharmacy Benefit Manager (“PBM”). Upon completion of the audit, the PBM issued audit findings wherein it alleged various discrepancies including failure to... Read More
Frier Levitt recently helped an Arizona-based independent pharmacy that was being audited by a national PBM. The PBM alleged various audit discrepancies including inadequate proof of delivery and missing signature logs. These alleged discrepancies... Read More
Physician groups contracting with government-regulated health plans such as Medicare-Advantage Organizations, Medicaid Managed Care Organizations, or ACA Marketplace Individual/Small Group Issuers often enter into capitated payment models with... Read More
Frier Levitt successfully lifted a payment suspension imposed by a major Pharmacy Benefit Manager ("PBM") upon an independent pharmacy based in New York. The PBM effectuated the payment suspension shortly after conducting an audit but prior to... Read More
Frier Levitt recently assisted a New Jersey-based specialty pharmacy audited by a large health plan and its PBM which had placed over $500,000 at issue through various audit discrepancies, including alleged invalid prescriptions, insufficient proof... Read More
Frier Levitt recently helped a New York-based independent pharmacy that was being audited by a PBM. Frier Levitt worked with the pharmacy and the PBM to successfully reduce the audit discrepancies by more than 90%. The PBM alleged various audit... Read More
Frier Levitt recently assisted a New York-based independent pharmacy that was placed under temporary payment suspension by a national Pharmacy Benefit Manager (“PBM”). Notably concerning, the temporary suspension was effectuated while the... Read More
Frier Levitt was recently successful in reversing a Midwest pharmacy’s enrollment application denial by a major Pharmacy Benefit Manager (“PBM”). The PBM denied the pharmacy’s enrollment application alleging that the pharmacy was previously... Read More
Frier Levitt recently assisted an independent pharmacy based in New York that was being audited by a national pharmacy benefit manager (PBM). During the course of the audit, the PBM alleged various audit discrepancies including drug invoice... Read More
