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
Frier Levitt recently assisted Texas-based independent pharmacy that was facing a Fraud, Waste, and Abuse audit conducted by a major Pharmacy Benefit Manager (“PBM”) and successfully reduced the audit chargeback from over $1.3M to $190K. The... Read More
Frier Levitt previously reported that certain Direct and Indirect Remuneration (“DIR”) fee reports would be available soon from Pharmacy Benefit Managers (“PBMs”) and last week, a major PBM distributed its report to providers. Often, PBMs... Read More
Frier Levitt recently helped a Utah-based independent pharmacy who was facing a Fraud, Waste and Abuse audit conducted by a PBM and successfully reduced the audit chargeback from over $1.4M to a little over $800. The PBM alleged that the Pharmacy... Read More
A group of New York BlueCross BlueShield health plans have filed suit against Walgreens, the largest community pharmacy chain, in U.S. District Court for the Northern District of Illinois alleging Walgreens inflated usual and customary (U&C)... Read More
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
Frier Levitt has noticed a recent uptick in pharmacies experiencing issues with not consistently receiving payments from certain PBMs – including OptumRx – on clean claims. This could involve untimely payments, unreconciled payments or payments... Read More
In May 2019, Oklahoma passed the Patient Right to Pharmacy Care Act ("Act"). The Act takes aim at unfair pharmacy benefit manager (“PBM”) practices by expanding network access for independent pharmacies, prohibiting PBMs from requiring patients... Read More
https://youtu.be/2_gV4rVqNBA Frier Levitt Co-Founding Partner Jonathan Levitt, Esq. and NYC Office Managing Partner John Morrone, Esq. discuss the COVID-19 pandemic’s effects on co-pay waivers. Watch for a better understanding of co-pay waivers... Read More
As PBMs continue to aggressively review participation in their retail pharmacy networks, several pharmacy providers find themselves at risk of termination over seemingly minor issues. For example, Frier Levitt recently assisted an Illinois-based... Read More
