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
Articles | Defending Pharmacies in PBM Audits | News | Recent Results | Recent Successes

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
Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Fertility Pharmacies | Home Infusion Providers | Integrated Delivery Network and Hospital System Pharmacy | Long-Term Care Pharmacies | 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)

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
Articles | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Fertility Pharmacies | Integrated Delivery Network and Hospital System Pharmacy | Payor Network Access and Defense of Network Terminations | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A)

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
Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Recent Results

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
Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Life Sciences | Pharmacy Law | Uncategorized

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
Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Articles | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Fertility Pharmacies | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A)

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
Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Fertility Pharmacies | Long-Term Care Pharmacies | News | Recent Results | Recent Successes | Specialty Pharmacies | Supermarket Pharmacies | Traditional Compounding Pharmacies (503A)