State legislative initiatives to regulate Pharmacy Benefit Managers (“PBMs”) have gained momentum.  Arkansas successfully defended its state PBM regulation in 2020 before the United States Supreme Court.  Now, more states have been enacting... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Regulatory Compliance, including FDA, DEA and HIPAA

As we reported here, Plan Sponsors have begun elevating their challenges of Pharmacy Benefit Managers’ (“PBMs”) and Managed Care Organizations’ (“MCOs”) conduct, from PBM pricing  to auditing and litigating over PBM practices such as... Read More
Blogs & Articles | Community, Retail Pharmacies | Life Sciences | Pharmacy Law | Plan Sponsor PBM Contract Services

A piece of legislation aimed at regulating pharmacy benefit managers (PBMs) and protecting Independent Pharmacies in the State of Tennessee recently passed through the State’s House and Senate and was subsequently signed into law by Governor Bill... Read More
340B Covered Entity and Contract Pharmacy Regulatory and Contract Support | Blogs & Articles | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law | Section 340B In-House and Contract Pharmacies | Specialty Pharmacies

https://youtu.be/g2dpr-g6sCQ Pharmacies must stay vigilant in the MAC process. Frier Levitt’s Jonathan Levitt, Esq. and Lucas Morgan, Esq. talk about MAC Laws and what’s new with Maximum Allowable Cost Appeals in our latest video. Learn what... Read More
Life Sciences | MAC Pricing & Appeals | Maximum Allowable Cost Pricing & Appeals | Pharmacy Law | Videos

A bipartisan piece of legislation aimed at regulating pharmacy benefit managers (PBMs) in the State of Texas unanimously passed the House and Senate in Texas. Specifically, House Bill (HB) 1763 previously passed the Texas House by a vote of 147-0... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | DIR Fees | Life Sciences | Payor Network Access and Defense of Network Terminations | Pharmacy Law

On April 12, 2021, Senator Kolkhorst, along with a bipartisan group of cosponsors, introduced SB 2195, a Bill that prohibits Pharmacy Benefit Managers (“PBMs”) operating in Texas from assessing against pharmacies a variety of different types of... Read More
Blogs & Articles | Community, Retail Pharmacies | DIR Fees | Life Sciences | Payor Network Access and Defense of Network Terminations | Pharmacy Law

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