PBM Audits & Defense
Network audits, recoupments, terminations, and appeals against Caremark, OptumRx, Express Scripts, and other PBMs.
PBM Audits: Proven Strategies, Practical Insights, and Expert Guidance
PBM audits extend beyond paperwork, assessing pharmacy operations, staff preparedness, SOPs, and compliance culture. Proactive str…
Navigating PBM Audits in 2025: A Guide for Pharmacies
Navigate 2025 PBM audits confidently: Key triggers, trends, and preparation tips to protect your pharmacy.
Common PBM Audit Triggers and How to Avoid Them
Guide independent pharmacies in recognizing and proactively managing specific behaviors and operational trends that commonly lead…
Enforcement of Arbitration Clauses in PBM Network Agreements: A Guide for Pharmacy Owners
This article explains arbitration clauses in Pharmacy Benefit Manager (PBM) network agreements, outlining when these clauses can b…
HLA Convinces Optum to Reverse PBM Audit Termination
Health Law Alliance is pleased to announce that Optum recently agreed to reverse its network termination of a Texas pharmacy clien…
HLA's Lawsuit Against Optum Achieves Return of Hundreds of Thousands of Dollars in Withheld Reimbursement
Health Law Alliance's lawsuit against Optum has resulted in the immediate release of hundreds of thousands of dollars in reimburse…
Triumph Over Optum: HLA’s Tenacious Advocacy Reverses Optum’s Termination of a Texas Pharmacy
Health Law Alliance successfully reversed Optum’s termination of a Texas pharmacy from its network, protecting the pharmacy from s…
HLA Files Emergency Texas Lawsuit Against Optum PBM Audit Termination
Health Law Alliance announces the filing of an emergency lawsuit in federal court for the Northern District of Texas, Dallas Divis…
Victories Against Optum Rx: Protecting Pharmacy Clients Nationwide
Health Law Alliance has successfully challenged Optum Rx's termination decisions for numerous pharmacies, ensuring they can contin…