Frier Levitt successfully lifted a payment suspension imposed by a major Pharmacy Benefit Manager ("PBM") upon an independent pharmacy based in New York. The PBM effectuated the payment suspension shortly after conducting an audit but prior to... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Recent Results | Recent Successes | Specialty Pharmacies

Pharmacy Benefit Managers (PBMs) routinely request pharmacies to submit credentialing when seeking admission into their networks, and require re-credentialing applications to be submitted two to three years after the pharmacies’ admission. The... Read More
Blogs & Articles | Community, Retail Pharmacies | Life Sciences | Payor Network Access and Defense of Network Terminations | Pharmacy Law

The current United States marketplace for the regulation of pharmacy benefits is a patchwork of inconsistent (and in some cases non-existent) state laws, state and federal agency regulations, agency manuals and federal laws. Uniform state laws would... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Life Sciences | Plan Sponsor PBM Contract Services

Frier Levitt successfully reversed a five year wait for readmission for an independent pharmacy into one of the largest Pharmacy Benefit Managers (“PBM”) pharmacy networks.  More specifically, the pharmacy was terminated by the PBM in 2017 for... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Life Sciences | Payor Network Access and Defense of Network Terminations | Pharmacy Law | Recent Results | Specialty Pharmacies

On July 30, 2019, the Commonwealth of Puerto Rico passed the Pharmacy Services and Benefit Managers Regulatory Act (the “Act”), and the relevant portions of the Act took effect in November 2019. Its effects may have gone largely unacknowledged... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Specialty Pharmacies

Independent retail and specialty pharmacies have long been concerned about perceived “steering” by Pharmacy Benefit Managers (“PBMs”), a practice in which a PBM in some manner channels prescriptions to its own wholly owned retail mail-order... Read More
Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Specialty Pharmacies

As another independent pharmacy closed its doors last week in Connecticut, the owner of the pharmacy identified that the rising costs of operations and direct and indirect remuneration (DIR) fees along with the decreasing reimbursement rates each... Read More
Defending Pharmacies in PBM Audits | DIR Fees | Fertility Pharmacies | Life Sciences | Pharmacy Law | Specialty Pharmacies