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
Frier Levitt recently received an impressive $3.6 million arbitration award against Caremark and SilverScript on behalf of a specialty pharmacy client, Mission Wellness, arising from improper DIR Fees. Despite repressive "gag clauses" imposed by... Read More
After a PBM terminated our pharmacy client from its pharmacy Network, Frier Levitt successfully reversed the termination following an appeal and communication with the PBM. The PBM sent a Notice of Termination our client alleging that the pharmacy... Read More
Last week, Frier Levitt discussed here that Caremark overturned certain aspects of the bulk purchase restriction that was imposed on pharmacies earlier this year. Specifically, Caremark required pharmacies to request permission in writing prior to... Read More
As Frier Levitt reported here, earlier this year, CVS Caremark (“Caremark”) implemented a notification requirement for pharmacies making bulk purchases. Pharmacies that were looking to make bulk purchases that exceeded a “30 day supply”... Read More
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
