Independent retail and specialty pharmacies have long been concerned about perceived “steering” by Pharmacy Benefit Managers (“PBMs”), a practice in which a PBM in some manner channels prescriptions to its own wholly owned retail mail-order... Read More
As another independent pharmacy closed its doors last week in Connecticut, the owner of the pharmacy identified that the rising costs of operations and direct and indirect remuneration (DIR) fees along with the decreasing reimbursement rates each... Read More
Pharmacy Benefit Managers (PBMs) regularly audit independently-owned pharmacies and seek recoupments on allegedly discrepant claims for a number of different bases. Recently, Frier Levitt has seen an uptick in the number of audits whereby PBMs have... Read More
On Friday January 10, 2020, the Supreme Court of the United States granted a petition for a writ of certiorari filed by the State of Arkansas wherein the Attorney General of Arkansas, Leslie Rutledge, asked the Court to review the U.S. Court of... Read More
As legal counsel to providers in an ever-changing healthcare landscape, Frier Levitt recognizes the importance of monitoring proposed, pending and recently enacted legislation and/or rulemaking that affects our clients. From time-to-time,... Read More
To the dismay of consumers and independent pharmacists, Governor Cuomo recently vetoed legislation passed by the state Legislature in June, designed to license and oversee pharmacy benefit managers ("PBMs"). The Bill, S. 6531, was endorsed by the... Read More
Recent enforcement actions over allegations regarding assisting pharmaceutical manufacturers to pay improper kickbacks to Medicare beneficiaries are not the only issues currently impacting Patient Assistance Programs (PAPs). PBMs are also taking an... Read More
As the calendar year comes to an end, Pharmacy Benefit Managers (PBMs) often review pharmacies that participate in their networks. Such reviews may include an evaluation of past audit performances or any past adverse action taken against the... Read More
In September 2018, New Jersey Governor Phil Murphy announced that the State of New Jersey awarded the Pharmacy Benefit Manager (PBM) contract to OptumRx and agreed to pay OptumRx $6.7 billion over three years to manage and administer pharmacy... Read More
Frier Levitt successfully saved over $1.6 Million for an independent pharmacy located in Texas against a desktop-audit conducted by a major Pharmacy Benefit Manager (PBM). The PBM claimed several different discrepancies, including inventory... Read More
