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

The United States drug supply chain is dominated by three vertically integrated Pharmacy Benefit Managers (“PBMs”) that are owned under the same corporate umbrella as the largest insurance companies, specialty pharmacies and chain pharmacies. ... Read More
Blogs & Articles | Life Sciences | Pharmacy Law | Plan Sponsor PBM Contract Services

https://youtu.be/sCUAjwc-wdg Frier Levitt’s Jonathan Levitt, Esq. and Lucas Morgan, Esq. talk about PBM Audit Fees in our latest video!  Learn about what a PBM audit fee is, what plan sponsors need to know, laws that pharmacies should be aware... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Pharmacy Law | Plan Sponsor PBM Contract Services | Videos

Frier Levitt's Plan Sponsor Co-Chairs Jonathan Levitt, Esq., and Dae Lee, Pharm.D., Esq., CPBS, Author Article for BenefitsPRO on Plan sponsors losing manufacturer rebate dollars to PBMs through rebate aggregators.   Pharmacy benefit managers... Read More
Blogs & Articles | Life Sciences | News & Press | Pharmacy Law | Plan Sponsor PBM Contract Services

As we have reported in prior manufacturer rebate articles, Pharmacy Benefit Managers (“PBMs”) have created opaque manufacturer rebate arrangements, either directly or through wholly owned subsidiaries. These subsidiaries are “Rebate... Read More
Blogs & Articles | Life Sciences | Pharmacy Law | Plan Sponsor PBM Contract Services

Frier Levitt recently obtained a $6.25 Million settlement against a Pharmacy Benefits Manager(“PBM”) on behalf of its Plan Sponsor client (“Plan”). The Plan contracted with the PBM to administer its prescription drug program, and to... Read More
Blogs & Articles | Life Sciences | Pharmacy Law | Plan Sponsor PBM Contract Services | Recent Results | Recent Successes

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

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
Blogs & Articles | Defending Pharmacies in PBM Audits | Life Sciences | Plan Sponsor PBM Contract Services

In September 2018, New Jersey Governor Phil Murphy announced that the State of New Jersey awarded the PBM contract to OptumRx and agreed to pay OptumRx $6.7 billion over three years to manage and administer pharmacy benefits for the State. Under New... Read More
Blogs & Articles | Defending Pharmacies in PBM Audits | Pharmacy Law | Plan Sponsor PBM Contract Services