Pharmacies across Texas are facing heightened enforcement and increased scrutiny by the Texas Board of Pharmacy (“BOP”). In recent months, aggressive investigators have conducted surprise visits to pharmacies. In some cases, the BOP has gone so far as to ask pharmacists to surrender their license on the spot.
If you are targeted by the BOP or other agency, it is critical to not say or do anything unless you fully understand the implications. In addition, it is always advisable to have a witness so investigators cannot twist statements to support their position.
Like PBM audits, your statements can be recorded and used against you. Therefore, before the underlying facts and circumstances become clear, it is advisable to not take a position on anything absent legal representation.
Likewise, get prepared. Don’t wait for an investigation to arise before you take steps to protect yourself. If you are aware of areas of potential concern, whatever they may be, let us help you address them.
In a highly regulated industry like healthcare, there are often grey areas around compliance. Although these areas present opportunities, some degree of risk comes with everything.
If and when someone disagrees with the approach your business has taken, all processes involved will be heavily scrutinized and tested. Your decision-making and compliance efforts likewise will be second-guessed.
In short, act proactively to insulate your livelihood from attack, whether that be from the Texas Board or any other regulator. And if you are already dealing with an investigation or discrepant PBM audit that could be referred to regulators, don't wait to take defensive action. Schedule a free consultation now.
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 severe financial and reputational damage. Our healthcare attorneys used strategic legal expertise and negotiations to overturn the decision, ensuring the pharmacy could continue serving patients. This victory highlights our dedication to strong advocacy and proven results.
Read More >>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 be enforced and how they affect dispute resolution for pharmacies.
Read More >>U.S. Justice Department Investigates Alleged Medicare Fraud Involving COVID-19 Test Kits
The U.S. Justice Department is investigating allegations of Medicare fraud, where senior citizens' ID numbers were used to order unwanted COVID-19 test kits. Learn more about the ongoing investigation and its implications.
Read More >>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 client despite significant claim discrepancies based on inventory shortages, patient denials, and other alleged violations of the terms and conditions of the Provider Manual and network enrollment agreements.
Read More >>