Frier Levitt recently assisted a New York-based Physician in challenging and resolving an improperly implemented Focused Professional Peer Evaluation (“FPPE”) by a New York Hospital. A FPPE is a process used by hospitals and other healthcare... Read More
Frier Levitt was recently successful in reversing a plan-initiated PBM network termination for NJ pharmacies that are under common ownership. Back in 2019, the PBM conducted an audit over the pharmacies on behalf of its plan client and alleged... Read More
Frier Levitt helped a New York pharmacy successfully appeal initial audit results in their entirety that were issued by a large PBM. Despite the pharmacy’s submission of purchase information directly from its wholesalers, the PBM alleged... Read More
Frier Levitt recently assisted a New Jersey pharmacy client in successfully challenging a major Pharmacy Benefit Manager’s (“PBM”) audit findings and reversing 100% of the purported discrepancies. During the audit, the PBM asserted allegations... Read More
Frier Levitt successfully helped a Louisiana-based pharmacy resolve a finding for overpayment from a large insurance plan, who demanded a significant sum of money be returned to the plan on the basis that prior authorizations obtained by the... Read More
Frier Levitt successfully assisted a Georgia-based pharmacy in securing reimbursement exceeding $1.2 million due and owed to the pharmacy from a major Pharmacy Benefit Manager (“PBM”). The PBM conducted multiple audits of the pharmacy including... Read More
A New York-based pharmacy client was facing an audit conducted by a major pharmacy benefit manager (“PBM”). During the audit, the PBM conducted an invoice reconciliation, causing it to assert thousands of unsubstantiated claims. In fact, the PBM... Read More
An Ohio-based pharmacy client was recently placed on payment suspension due to alleged inventory shortfalls during a Pharmacy Benefit Manager (“PBM”) audit before initial audit results were even issued, leaving the pharmacy with limited to no... Read More
Frier Levitt was recently successful in assisting a California-based specialty pharmacy client in recovering claims pertaining to a major PBM’s error in interpreting California refill laws. Our attorneys were able to extensively review the... Read More
Frier Levitt was recently successful in assisting a New Jersey-based specialty pharmacy with the reversal of a full audit chargeback of over $100,000 plus the additional audit fee. A major PBM had conducted an extensive audit on the pharmacy and... Read More
