As a follow-up to our May 18, 2021 article, the bipartisan piece of legislation that unanimously passed the Texas House and Senate aimed at regulating pharmacy benefit managers (PBMs) was signed into law by Governor Greg Abbott. This is a huge win... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | DIR Fees | Life Sciences | Pharmacy Law

Physician groups contracting with government-regulated health plans such as Medicare-Advantage Organizations, Medicaid Managed Care Organizations, or ACA Marketplace Individual/Small Group Issuers often enter into capitated payment models with... Read More
Blogs & Articles | Healthcare | Healthcare Law | Healthcare Litigation | Medicare and Insurance Audits | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals | Recent Results | Recent Successes | Value Based Care | Value Based Care

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
Blogs & Articles | Community, Retail Pharmacies | Life Sciences

The current United States marketplace for the regulation of pharmacy benefits is a patchwork of inconsistent (and in some cases non-existent) state laws, state and federal agency regulations, agency manuals and federal laws. Uniform state laws would... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Life Sciences | Plan Sponsor PBM Contract Services

Frier Levitt Co-Founder Jonathan Levitt, Partner Jesse Dresser and pharmacist-attorney Dae Y. Lee recently authored an article for Managed Healthcare Executive on "Why Timing Matters When It Comes to PBM Contracting."  Timing plays a... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Plan Sponsor PBM Contract Services