As the Pharmacy Benefit Managers (PBMs) prepare for the end-of-year “housekeeping”, pharmacies should be aware of the PBM audit trends and arm themselves with information necessary to preempt—and strategies to outright avoid—falling victim... Read More
Antitrust Review and Compliance | Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Articles | Biotech Companies | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Fertility Pharmacies | Integrated Delivery Network and Hospital System Pharmacy | Long-Term Care Pharmacies | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A) | Uncategorized

Frier Levitt has been closely monitoring Express Scripts’ (“ESI”) administration of TRICARE, the health care program for uniformed service members and their families. Earlier this year the Defense Health Agency (“DHA”) awarded ESI a... Read More
Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Uncategorized

As we begin to enter the holiday season, pharmacies need to be cognizant that not everyone is eager to dive into the holiday spirit. Indeed, for pharmacy benefit managers (“PBMs”), the holiday season is merely the starting point of year-end... Read More
Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Fertility Pharmacies | Home Infusion Providers | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A)

The deadline for Plan Sponsors to submit considerable and illusive drug spend data required under the Consolidated Appropriations Act (“CAA”) is December 27, 2022. The CAA requires group health plans and health insurers to submit prescription... Read More
Articles | Plan Sponsor PBM Contract Services

Independent pharmacies and providers must be vigilant based on a recent uptick in network terminations (many of which are not justified) by pharmacy benefit managers (“PBMs”) throughout the country. The fact that PBMs will often issue... Read More
Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Articles | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Fertility Pharmacies | Long-Term Care Pharmacies | Payor Network Access and Defense of Network Terminations | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A)

Rising drug prices have forced consumers to seek out and utilize the most affordable sources to obtain their prescription medications. Whether it’s through commercial insurance, prescription discount cards, or manufacturer assistance programs,... Read More
Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Articles | Chain Pharmacies | Clinically Integrated Networks (CINs) | Community Oncology Practices & Other Dispensing Physician Practices | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Fertility Pharmacies | Hospitals and Healthcare Systems | Integrated Delivery Network | Integrated Delivery Network and Hospital System Pharmacy | Physician Dispensing | Regulatory Compliance, including FDA, DEA and HIPAA | Risk Assessment Mitigation Strategy | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A)

A recent U.S. Supreme Court decision in the case of Ruan v. United States clarified the “intent element” in prosecutions of physicians for violations of the federal Controlled Substances Act (“CSA”) that are based on allegations... Read More
Articles | Life Sciences | Pain Management Compliance | Pharmacy Law | Physician Dispensing | Regulatory Compliance, including FDA, DEA and HIPAA