Frier Levitt Co-Managing Partner, Jonathan E. Levitt, has issued a public letter to Elon Musk urging the Department of Government Efficiency (DOGE) to investigate the massive waste and unchecked self-dealing within the Medicare drug benefit system. Medicare Plans are currently permitted to give “no bid” contracts affiliated Pharmacy Benefit Managers (“PBMs”) with no incentives to drive down drug costs. PBMs often require that high-cost drugs, including biosimilars manufactured by PBM affiliates, are covered over cost efficient non-formulary alternatives – resulting in billions of dollars of unnecessary drug expenditures.
Through Freedom of Information Act (FOIA) requests and publicly available information, we’ve uncovered alarming facts:
- PBMs control the vast majority of Medicare Part D drug benefit management—without meaningful oversight by CMS.
- After conducting reasonable searches for records, CMS was unable to locate records of audits, warning letters, or other enforcement actions issued to Medicare Part D Plan sponsors or any first tier, downstream, and related entities for noncompliance with various Medicare requirements.
- Patients, physicians, and taxpayers are paying the price for high cost drugs, while PBMs and their affiliated pharmacies profit.
The Call to Action: Frier Levitt is requesting an audit of PBM rebate structures and policy reforms to curb Medicare waste. Billions of dollars can be saved—if action is taken now.
Co-Managing Partner