An Ohio-based pharmacy client was recently placed on payment suspension due to alleged inventory shortfalls during a Pharmacy Benefit Manager (“PBM”) audit before initial audit results were even issued, leaving the pharmacy with limited to no... Read More
In the course of pharmacy audits, PBMs are increasingly requesting from pharmacies copies of Drug Supply Chain Security Act (“DSCSA”) track and trace documents, commonly known as “T3” documentation. The T3, which consists of the Transaction... Read More
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
Last month, several pharmacies participating in a major PBM’s networks received notices about their Hub relationships. Pharmacies were reminded of their inability to enter into Hub arrangements without prior consent from the PBM and were directed... Read More
Frier Levitt recently assisted a Florida-based retail pharmacy in overcoming a substantial number of discrepancies raised during a PBM audit. The PBM alleged that the pharmacy had several discrepancies, including invalid proof of a patient’s... Read More
Pharmacy Benefit Managers (PBMs) routinely request that pharmacies submit credentialing and re-credentialing applications, which require pharmacies to provide complete ownership information. In addition, PBMs require that pharmacies identify any... Read More
As pharmacies operate in a highly regulated landscape, it is important to work with a highly experienced attorney with industry knowledge to guide a potential buyer of any pharmacy. In this article, we highlight some of the key areas of focus when... Read More
Pharmacy Benefit Managers (“PBMs”) regularly review network pharmacies to ensure that they are meeting terms and conditions identified in their Provider Agreements and Pharmacy Manuals. One mechanism for this review includes audits and... Read More
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