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
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Some PBMs require that pharmacies purchase diabetic testing supplies from “authorized distributors.” While the term varies from manufacturer to manufacturer, an authorized distributor is essentially an approved wholesaler that is contracted with... Read More
Blogs & Articles | Life Sciences | Manufacturers | Pharmaceutical Wholesalers

On October 6, 2020, oral argument was entertained by the Supreme Court of the United States (“SCOTUS”) in Rutledge v. Pharmaceutical Care Management Association (PCMA), the first case to reach the high court challenging a State’s ability to... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences | Pharmacy Law

In a recent but aggressive trend, Elixir (formerly known as Envision Rx) has begun to issue payment and claim submission notices of suspension to pharmacies generally alleging that the pharmacies have engaged in or are engaging in activity or... Read More
Blogs & Articles | Community, Retail Pharmacies | Defending Pharmacies in PBM Audits | Life Sciences