Defending Pharmacies in PBM Audits

Frier Levitt fights PBMs on behalf of pharmacies and has achieved success in audit related litigation. We have experience dealing with Express Scripts, Medco, Caremark, Catamaran, Blue Cross/Blue Shield, Walgreens, Blue Care Network and other PBMs during the audit stage, and in arbitration proceedings following the PBM audit. We have seen first-hand how onerous a PBM audit can be to you and your pharmacy.

Frier Levitt possesses a thorough knowledge and a nuanced understanding of many of the PBMs’ written agreements with their network pharmacies, and consequently is prepared to take an aggressive approach to fight for your rights following the audit and in arbitration/litigation.

Frier Levitt ‘s Results Against PBMs

Frier Levitt obtained injunctive relief against a national PBM prohibiting the PBM from retracting monies from pharmacies. The PBM had unilaterally and unjustly decided to “retract” in excess of $1 million from two pharmacies. The court disagreed with the PBM and granted Frier Levitt’s proposed injunction, preventing the PBM from “retracting” the money from the pharmacies. The injunction allowed our clients to continue to operate their businesses while the matter is being arbitrated, without suffering the devastating effects of the onerous and unexplained retractions. This may have been the first time that a national PBM has been enjoined from retracting from a pharmacy and we are proud to have obtained this result on behalf of our pharmacy clients. The injunction was subsequently “dissolved”, but only after the PBM clarified to the court their retraction process.

Regardless of the size of your pharmacy or the amount at stake as a result of the audit, Frier Levitt is ready to assist you in successfully challenging the audit. If you have questions or need help with a PBM Audit, contact Frier Levitt today.