State and National Pharmacy Associations

Drawing on decades of frontline representation, we help associations and their members interpret and comply with federal and state requirements while anticipating changes that affect reimbursement, audits, network access, and operational viability. To complement the many knowledgeable attorneys and legal experts at the firm, Frier Levitt also features several clinician-attorneys. Clinician-attorneys are part of the fabric of Frier Levitt because we want our pharmacy clients, including State Pharmacy Associations, to be assured that we speak their language and understand their challenges.  Frier Levitt’s team of legal experts, are consistently uncovering new ways that they can help pharmacies and State Pharmacy Associations navigate the continuously changing Federal and State legal landscape including applicable laws and regulations to ensure they understand the law and are complying with the law.

We understand the reimbursement pressures pharmacies face and the levers associations can pull to address them. Our dedicated team analyzes state laws, PBM contracts, and reimbursement methodologies to challenge unfair practices and support policy reforms. We assist providers in communicating with PBMs, crafting legislative solutions, preparing amicus curiae briefs in pivotal cases, and pursuing litigation or arbitration where appropriate. We also have extensive experience recovering hundreds of millions of dollars in Direct and Indirect Remuneration “DIR” fees wrongfully taken by PBMs in addition to recovering millions in Generic and Brand Effective Rate fees and fighting for providers to ensure proper reimbursement based on state Maximum Allowable Cost “MAC” laws. Because post point of sale fees are assessed retroactively and non-transparently, we help providers develop strategies to mitigate uncertainty, challenge improper fee structures, and leverage favorable laws and guidance where available. In parallel, we address patient steering from independent pharmacies to PBM-owned or affiliated pharmacies, including by evaluating plan designs and network terms for anti-competitive steering mechanisms, enforcing patient choice and any willing provider protections where applicable, scrutinizing network adequacy and tiering practices, and advancing policy and litigation strategies to deter discriminatory steering and preserve access to independent pharmacies.

Frier Levitt collaborates with State and National Pharmacy Associations on policy development, legislative drafting, and government affairs to counterbalance pro-PBM lobbying groups, including the Pharmaceutical Care Management Association (PCMA), influence. We factor in critical doctrines such as ERISA and Medicare preemption during drafting to enhance durability against legal challenges. It is critical that these doctrines are considered in the legislative drafting process as failure to account for them can be costly if a recently enacted law is later challenged. Our team supports associations through testimony preparation, stakeholder engagement, and coalition-building to advance balanced, enforceable pharmacy reforms.