False Claims Act (“FCA”) cases brought by the Department of Justice (“DOJ”) returned only $2.2 billion in recovered funds in 2020, down from $3.0 billion in 2019 and $2.9 billion in 2018, making 2020’s FCA recovery amount the lowest since... Read More
The last few years have brought on a slew of litigation aimed at combatting the opioid epidemic. Most recently, however, a complaint has been lodged against the United States, which has great potential to shape future litigation. Specifically, on... Read More
Express Scripts, Inc. (“ESI”), has switched gears once again in its recoupment efforts that originally began on April 7, 2020, and re-initiated by ESI on September 1, 2020 . ESI unilaterally recoups funds from pharmacies based on an alleged... Read More
Express Scripts, Inc. (“ESI”), following a period of stay in its April 7, 2020 recoupment action, has resumed its efforts to recover funds from certain pharmacies who submitted claims to TRICARE in 2015, this time, with no indication of slowing... Read More
This week, a new phenomenon began to emerge, impacting compounding pharmacies that previously received letters dated April 7, 2020 from Express Scripts, Inc. (“ESI”) initiating recoupment actions. At the request of the Defense Health Agency... Read More
At the request of the Defense Health Agency (“DHA”), Express Scripts, Inc. (“ESI”) has begun sending letters to some of the pharmacies within its network recouping on claims that had been submitted to TRICARE. This recent batch of letters is... Read More
The role of the pharmacist is continuously evolving. President Trump's October 2019 Executive Order 13890, which seeks to improve access to healthcare for Medicare patients, sparked arguments from the National Community Pharmacists Association... Read More
