Independent pharmacies face growing challenges in an ever-changing healthcare marketplace. Increasingly, pharmacy benefit managers (“PBM”) are acquiring and operating their own pharmacies to compete with independent pharmacies. PBMs are aggressively targeting independent pharmacies through a variety of means, including narrower pharmacy networks, lower reimbursements, more aggressive MAC (maximum acquisition costs) erosion, direct and indirect remuneration (“DIR”) fees, below-acquisition cost reimbursement, PBM transparency issues, mail-order restrictions, and PBM audits.

The Duane Morris Pharmacy Litigation Group consists of litigators, healthcare regulatory and corporate attorneys who have significant experience in the many segments of the industry, including retail, closed door, mail service, internet, infusion, and institutional pharmacies. Our services include:

  • Negotiation and compliance with contractual, regulatory and operational requirements, including FDA, DEA, Medicare Part D and Medicaid regulations
  • Advice on licensure issues
  • Practical dispute resolution strategies and support for pharmacy contract and reimbursement issues, including improper pharmacy benefit network terminations or exclusions
  • Assistance with regulatory and contractual audits and compliance reviews initiated by PBMs
  • Guidance on HIPAA obligations, security breaches, diversion or theft of controlled substances, e-prescribing, internet prescribing, co-payment assistance programs, fraud and abuse analyses, and 340b matters
  • Enforcement of non-competes and other business protection strategies
  • Counsel throughout the pharmacy merger and acquisition process, including evaluation, due diligence and negotiations

For More Information

For additional information, please contact Jonathan L. Swichar, Erin M. Duffy or any of the group members referenced in the Attorney Listing.