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

Has your pharmacy or dispensing practice recently received a remittance that included large “submission fees,” sometimes designated with the code “AH:444,” without explanation?  Frier Levitt has learned those fees are DIR fees being charged... Read More
Blogs & Articles | Community, Retail Pharmacies | DIR Fees | Life Sciences | Pharmacy Law

As part of an invoice reconciliation audit, Pharmacy Benefit Managers (“PBMs”) routinely request pharmacies to provide documents pertaining to pharmacy-to-pharmacy drug transfers.  These documents include invoices and/or purchase summaries from... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law

On Thursday December 10, 2020, the Supreme Court of the United States (SCOTUS) issued a unanimous decision in the case Rutledge v. PCMA ruling in favor of the Petitioner, Leslie Rutledge, the Attorney General of Arkansas, and against the... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law

On November 20, 2020, the Trump administration announced plans to scrap the Medicare Part D “rebate safe harbor,” which currently permits insurance middlemen called Pharmacy Benefits Managers (“PBMs”) to charge manufacturers substantial fees... Read More
Blogs & Articles | Industry | Life Sciences | Pharmacy Law | Plan Sponsor PBM Contract Services