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Pharmacy ALERT: Prime Therapeutics Heightens Investigative Efforts Against Pharmacies with Enhanced Oversight Addendums

Prime Therapeutics is notorious for taking an aggressive stance against its network pharmacies regarding enhanced credentialing criteria.  Over the past year, we have reported numerous instances whereby Prime has sought to terminate pharmacies for alleged credential non-compliance.  In recent weeks, Prime has taken steps to heighten its investigation into pharmacies that have signed Enhanced Oversight Addendums (EOA). These EOAs were offered to pharmacies participating in Prime’s networks in response to...

New DOJ False Claims Act Guidelines: Credit for Disclosure, Cooperation and Remediation

In May, the US Department of Justice (DOJ) issued revised guidelines regarding "taking disclosure, cooperation and remediation into account in False Claims Act (FCA) matters." These guidelines highlight the federal government’s interest in the voluntary disclosure of FCA violations by entities and individuals. The DOJ notes that "entities and individuals that make proactive, timely, and voluntary self-disclosure" to the government may be eligible to receive credit during the resolution of...