State and National Pharmacy Associations

Frier Levitt Represents State and National Pharmacy Associations

Pharmacist drawing medical iconsAs a national healthcare and life sciences boutique law firm, Frier Levitt has extensive experience representing all types of pharmacies throughout the United States including Independent Pharmacies, Compounding Pharmacies, and Specialty Pharmacies. In representing these various pharmacy providers, Frier Levitt has gained an in-depth understanding of the various legal issues and challenges that pharmacies face. More importantly, Frier Levitt has achieved successful results on behalf of its pharmacy clientele in response to these important legal issues. In addition to representing individual pharmacies, Frier Levitt also has extensive experience in representing larger organizations and associations that represent the interests of pharmacies including State Pharmacy Associations. In many cases, State-based Pharmacy Associations are uniquely positioned to address the complex legal issues confronting their pharmacy constituency in a more efficient and streamlined manner than individual pharmacies addressing daunting legal issues on an individual case-by-case basis. Frier Levitt has extensive experience working with State and National Pharmacy Associations and other similar organizations and associations and understands the opportunities available to Pharmacy Associations to address critical legal issues, including drafting legislation.

Understanding the Practice of Pharmacy

Frier Levitt represents State Pharmacy Associations throughout the United States. In its nearly 20-year history successfully representing pharmacies in a wide variety of matters, Frier Levitt has gained an extensive and detailed understanding of the various legal issues and challenges facing pharmacies. To complement the many knowledgeable attorneys and legal experts at the Firm, Frier Levitt also features several Clinician-attorneys. Clinician-attorneys are part of the fabric of Frier Levitt because we want our pharmacy clients, including State Pharmacy Associations, to be assured that we speak their language and understand their challenges.  Frier Levitt’s team of legal experts, including pharmacist-attorneys, are consistently uncovering new ways that they can help pharmacies and State Pharmacy Associations navigate the continuously changing Federal and State legal landscape including applicable laws and regulations to ensure they understand the law and are complying with the law.

In addition to ensuring a thorough understanding of the law and compliance with the law, Frier Levitt is highly qualified and well positioned to work with State Pharmacy Associations to take on the most pressing issues facing pharmacies throughout the country today including issues related to reimbursement such Maximum Allowable Cost (MAC) pricing, Direct and Indirect Remuneration (DIR) fees, and improper recoupments by PBMs in connection with unfair/improper audit and investigation practices.

Frier Levitt Comprehensively Understands Pharmacy Reimbursement Issues

There are numerous issues facing pharmacies and specifically the issue of pharmacy reimbursement. By way of example, MAC pricing is an important issue that has impacted numerous pharmacies throughout the country that many State Pharmacy Associations are well positioned to address on behalf of their members. MAC pricing specifically is a PBM created concept that harms Pharmacies as well as patients and payers in the long run. To address this crucial issue, Frier Levitt created a MAC Pricing Practice Group with attorneys that have spent years studying the various laws, rules, and regulations governing the establishment of MAC pricing as well as numerous PBM contracts including the various provisions related to reimbursement including MAC pricing. Frier Levitt can help State Pharmacy Associations find creative ways to address the legal issues related to MAC pricing including by working with State Pharmacy Associations to communicate with PBMs on this issue, taking appropriate legislative action, and also submitting legal briefs, including amicus curiae briefs, in connection with the most critical cases being litigated in the Federal and State court systems today. Frier Levitt also has extensive experience in litigation and arbitration against PBMs. Frier Levitt has authored and submitted legal briefs in numerous courts and in arbitrations throughout the United States including in the Supreme Court of the United States.

Frier Levitt also has extensive knowledge of other practices that impact State Pharmacy Associations and their constituents’ reimbursement and overall margins including the crucial issue of Direct and Indirect Remuneration Fees or DIR fees, net promoter score, generic effective rate or GER. Frier Levitt also has extensive knowledge of many of the laws already in place that in many cases are favorable and can help pharmacies with these reimbursement issues. DIR fees are a legal issue directly effecting pharmacy reimbursement that has become one of the most detrimental policies enacted by PBMs against pharmacies in recent history. PBMs have improperly manipulated the term “DIR” to justify the assessment of unreasonable fees on pharmacies in a non-transparent manner that directly impacts overall reimbursement. One of the most critical characteristics of DIR fees is that they are calculated retrospectively and therefore assessed against pharmacies many months after the pharmacies have been reimbursed on claims submitted to the PBM. The uncertainty of the amount of DIR fees, coupled with the impact on reimbursement, has had a profound impact on pharmacy operations throughout the country. Frier Levitt has gained a comprehensive understanding of DIR fees and has had numerous successes in addressing DIR fees on behalf of pharmacies including by working directly with State Pharmacy Associations.

In addition to being well versed in handling legal issues that directly affect pharmacy reimbursement, Frier Levitt also has extensive working in the legislative arena, an area where State Pharmacy Associations are often better positioned to have an impact than individual pharmacies. Frier Levitt works directly with State and National Pharmacy Associations in lobbying efforts including in providing legal advice in the legislative drafting process to ensure that legislative efforts to combat improper PBM tactics are not defeated by pro-PBM lobbying groups, including the Pharmaceutical Care Management Association (PCMA), a powerful lobbying group representing exclusively the interests of PBMs. Frier Levitt understand the complex legal doctrines that PCMA relies on in challenging laws aimed at regulating PBMs’ practices including the doctrines of ERISA preemption and Medicare preemption. It is critical that these doctrines are considered in the legislative drafting process as failure to account for them can be costly if a recently enacted law is later challenged. 

How Frier Levitt Helps State and National Pharmacy Associations

Frier Levitt represents State Pharmacy Associations in a variety of legal matters and is capable of working with State Pharmacy Associations in a variety of creative ways to address the legal issues facing the Associations’ pharmacy constituents throughout the country. Whether addressing legal issues in a litigation setting or a legislative setting, Frier Levitt is equipped to handle the most important issues facing pharmacies today.  

Frier Levitt’s legal services related to State Pharmacy Associations include:

  • Associational and/or Representative Legal Proceedings including Class Action Lawsuits
  • Leveraging State Laws Prohibiting Post Point-of-Sale Recoupments
  • Addressing Network Access Issues
  • Lobbying, Legislative, and Government Affairs Matters
  • Working with State Pharmacy Associations on Educational Legislative Updates
  • Review of PBM contracts on behalf of Association members
  • Review of PBM provider agreements and manuals on behalf of members
  • Legal Issues Related to Direct and Indirect Remuneration fees aka DIR fees
  • Legal Issues Related to Maximum Allowable Cost (MAC) and MAC appeals

Frier Levitt provides tailored solutions to our clients, including State Pharmacy Associations, backed by nearly 20 years of experience in the healthcare and life sciences industry. For more information, contact Frier Levitt today to speak with an attorney.