PBM Audits & Defense
Network audits, recoupments, terminations, and appeals against Caremark, OptumRx, Express Scripts, and other PBMs.
Potential Windows of Opportunity
Health Law Alliance, specializing in PBM audit defense, highlights the potential benefits of discrepant PBM audits as early warnin…
Defending Inventory Shortfalls
Health Law Alliance addresses the complexities of defending against inventory shortfalls in the context of PBM audits, emphasizing…
Key PBM Audit Considerations
Health Law Alliance provides an overview of the PBM audit process and relevant background for providers who suddenly find themselv…
Inventory Shortfall Case Studies
Health Law Alliance, under Anthony Mahajan's leadership, celebrates favorable outcomes in federal and state cases involving invent…
How PBM Audits Can Provoke Government Scrutiny
Health Law Alliance's Anthony Mahajan discusses the potential outcomes and strategies related to Pharmacy Benefit Manager (PBM) au…
NYRx Transition May Increase Medicaid Program Risk
The transition of Medicaid pharmacy benefit to NYRx in New York brings increased dispensing fees but also heightened audit and enf…