The Court of Appeals for the Third Circuit recently issued its decision in the consolidated cases of drug manufacturers Sanofi, Novo Nordisk, and AstraZeneca ruling in the drug manufacturers favor versus the Department of Health & Human Services... 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
Frier Levitt was recently successful in reversing a New Jersey pharmacy’s network termination by a major PBM. The PBM had sent Notices of Termination alleging that the pharmacy failed to comply with terms and conditions of the PBM Provider... Read More
The Section 340B federal discount drug program (340B program) is a federal program under which pharmaceutical manufacturers enter into contracts with the U.S. Department of Health & Human Services (HHS) in exchange for obtaining Medicaid and... Read More
As independent pharmacies across the country look for ways to diversify and grow the scope of products available to their patients, many consider expanding into the durable medical equipment (DME) space, such as wheelchairs, walkers, crutches, and... Read More
Direct and indirect remuneration (DIR) fees paid by pharmacy providers to pharmacy benefit managers (PBMs) are on the rise for the upcoming calendar year in 2022. Pharmacy DIR fees have been utilized by PBMs to recoup monies on claims submissions... Read More
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
Under the Section 340B federal discount drug program (340B program), pharmaceutical manufacturers enter into contracts with the Health & Human Services (HHS) in exchange for having their drugs covered by Medicaid and Medicare. Pursuant to... Read More
In February 2020, Cigna announced that it would be terminating its contract with CareCentrix, the third party administrator that had managed home infusion therapy services for Cigna’s beneficiaries nationwide. The announcement indicated that the... Read More
Pharmacy benefits manager (PBM) Caremark has now placed Trimester 2 reports for year 2020 in the Caremark Provider Portal. Caremark provides its summaries of Direct and Indirect Remuneration (DIR) Fees paid by pharmacy providers in these... Read More
