On Monday, June 6, 2022, the Federal Trade Commission (FTC) voted unanimously to approve a “6(b)” study into the anti-competitive and abusive practices of Pharmacy Benefits Managers (PBMs), a move that has the potential to lead to significant... Read More
In yet another high-profile legal action, health insurance giant, Humana, has demonstrated its appetite to go after pharmaceutical manufacturers, supporting hubs and specialty pharmacies involved in patient assistance programs. This past week,... Read More
In September 2020, Frier Levitt described how Humana Pharmacy Solutions, Inc. and affiliated Humana entities (“Humana”) filed a lawsuit against a Florida-based telemedicine company, QuivvyTech Corp., and its affiliated physicians (“QuivvyTech... Read More
Following the release of an April 16, 2021 HHS Office of Inspector General (“OIG”) report entitled “Medicare Advantage Compliance Audit of Diagnosis Codes that Humana, Inc. (Contract H1036) Submitted to CMS” (the “OIG Report”), headlines... Read More
On August 20, 2020, Humana Pharmacy Solutions, Inc. (“Humana”) filed a lawsuit alleging, among other things, violations of the Racketeer Influenced and Corrupt Organizations Act (“RICO”) against a Florida-based company, Quivvy Tech Corp.,... Read More
In an effort made in response to the COVID-19 emergency thus far, as previously discussed in our posts, “What Are the PBMs Doing Amid COVID-19 Crisis: Waivers from Strict Requirements May Exist for Independent Pharmacies,” and “UPDATE: Humana... Read More
As previously discussed in our post, “What Are the PBMs Doing Amid COVID-19 Crisis: Waivers from Strict Requirements May Exist for Independent Pharmacies,” many healthcare companies alike are taking further actions to ensure that patients have... Read More
The Centers for Medicare & Medicaid Services (CMS) recently announced a final rule allowing Non-skilled in-home care services as a supplemental benefit for Medicare Advantage (MA) plans in 2019. This is first time CMS has allowed supplemental... Read More
While PBMs have scrutinized retail pharmacies for mailing activities for some time, over the last several weeks, several major PBMs have embarked on renewed tactics aimed at clamping down on pharmacies dispensing prescription medications to their... Read More
According to the 2015 Form 10-K filed by the drug manufacturer Insys Therapeutics, Inc., Humana began sending letters to its participating pharmacy providers in January 2016 "indicating that as a result of a CMS audit, Humana was initiating a... Read More
