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Frier Levitt Successfully Reverses Wrongful Termination of Pharmacies from PBM Networks

Frier Levitt has recently been successful in reversing wrongful terminations of pharmacies from Pharmacy Benefit Manager (PBM) networks. The PBMs agreed to reinstate the contractual terms with no interruption in service dates. PBMs perform routine audits on pharmacies which many times result in a number of discrepancy findings. If the pharmacy is unable to successfully contest these discrepancy findings, the PBM may present a notice of termination. In response to...

The FDA’s Role in Increasing Drug Competition in the Wake of Price Hikes

Pharmaceutical drug pricing is back in the national debate in the wake of Mylan's recent price increases to its EpiPen medication. This recent action has renewed the focus and attention by lawmakers and regulators alike, and once again raises the question of the role to be played by the Food and Drug Administration (FDA) in regulating drug pricing and ensuring drug competition in the wake of these recent drug price...

Unprecedented Department of Justice Health Care Fraud Takedown Results in 301 Individuals Charged Over More than $900 Million in False Billing

On June 22, 2016, Federal officials from the Justice Department, along with the FBI, HHS, and the Medicare Fraud Strike Force, announced civil and criminal charges against 301 individuals and medical professionals who allegedly charged Medicare and other government programs over $900 million in allegedly fraudulent billing. Many of the charges involve relationships and arrangements among various providers, marketers and marketing companies. The claims include conspiracy to commit health care...

Health Plans File RICO Suit Against Valeant and Philidor Over “Secret” Relationship Signaling Continued Scrutiny of Pharma-Pharmacy Relationships

On May 27, 2016, Valeant Pharmaceuticals was hit with a proposed class action accusing the drug company and its executives of violating the Racketeer Influenced and Corrupt Organizations (RICO) Act.  The suit – filed by two health care funds – alleged that Valeant fraudulently schemed to block Valeant's drugs from competition and ensure their selection and coverage through a "secret network of captive pharmacies" who acted uniquely to push Valeant's...

Vermont Enacts Law Addressing Sudden Drug Price Hikes Impacting the Manner of How Pharmaceutical Manufacturers Set and Report Prices for Drugs

On June 3, 2016, the Governor of Vermont signed into law a bill that would highlight drugs on which the State spends significant amounts of money, with the goal of regulating the drug manufacturers' setting of acquisition and list prices. Under the law, pharmaceutical companies producing those specific drugs could be fined up to $10,000 if the State determines that Wholesale Acquisition Cost (WAC) rises too quickly and the company...