Frier Levitt was recently successful in reversing a Midwest pharmacy’s enrollment application denial by a major Pharmacy Benefit Manager (“PBM”). The PBM denied the pharmacy’s enrollment application alleging that the pharmacy was previously... Read More
Blogs & Articles | Community, Retail Pharmacies | Life Sciences | Payor Network Access and Defense of Network Terminations | Pharmacy Law | Recent Results | Recent Successes

In a recent trend, pharmacies have begun receiving notices of termination not for billing errors or audit findings, but for claims inactivity. Specifically, several Pharmacy Benefit Managers, or PBMs, have been terminating pharmacies solely because... Read More
Blogs & Articles | Chain Pharmacies | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Payor Network Access and Defense of Network Terminations | Pharmacy Law | Specialty Pharmacies

Many pharmacies are faced with PBM audits resulting in final audit finding recoupments which can range from very large to very small dollar amounts. Many times, when the recoupment is smaller in sum, pharmacies may be inclined to forgo contesting... Read More
Blogs & Articles | Chain Pharmacies | Defending Pharmacies in PBM Audits | Digital Pharmacies | Life Sciences | Payor Network Access and Defense of Network Terminations | Pharmacy Law | Specialty Pharmacies

In a recent trend, the Blue Cross and Blue Shield Federal Employee Program (“FEP”), whose pharmacy benefits are administered by CVS Caremark, has been seeking an increasing amount of terminations of network pharmacy providers. Specifically, the... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Payor Network Access and Defense of Network Terminations | Pharmacy Law

Frier Levitt successfully reverses a PBM network termination on behalf of an Illinois pharmacy.  The PBM, which is wholly owned by a publicly traded company, conducted an onsite inspection of the Pharmacy and identified a number of expired drug... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Payor Network Access and Defense of Network Terminations | Pharmacy Law | Recent Results

The continuing COVID-19 pandemic has caused most business operations to go virtual, and PBMs have followed this trend. Earlier this year, we reported that PBMs had briefly suspended audits of pharmacies in an alleged effort to ensure pharmacies were... Read More
Blogs & Articles | Community, Retail Pharmacies | COVID-19 Resources | Defending Pharmacies in PBM Audits | Life Sciences