Insights & Analysis
Practical guidance on PBM audits, federal investigations, compounding defense, DEA enforcement, telehealth compliance, and the regulatory pressures facing pharmacies and providers nationwide.
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Department of Justice Declines to Prosecute HLA Client for Alleged $6M Fraud
After the Department of Justice threatened to indict our client for involvement in an alleged $6M healthcare fraud, we stood firm…
Federal Prosecutors Decline Criminal Prosecution of HLA Client
Following a PBM audit that uncovered a $6.5 million billing discrepancy, federal prosecutors opened an investigation. After HLA wa…
MFCU Agrees Not to Charge HLA Client Following PBM Audit Referral
PBM audits must be handled correctly or severe consequences may result. In this case, HLA was able to persuade prosecutors not to…
Understanding the Investigative Agencies in Healthcare
After the Department of Justice threatened to indict our client for involvement in an alleged $6M healthcare fraud, we stood firm…
DEA's Dangerous New Agenda
Although DEA has long targeted wholesalers as the "choke-point" for stemming diversion, the Agency has now shifted its focus to do…
DOJ Maintains Focus on Inventory Shortfalls
Department of Justice prosecutors continue to file numerous cases against pharmacies and their owners for inventory shortfalls and…
HHS-OIG Prioritizes 2024 Pharmacy Audits
Based on a recent announcement, the federal government (HHS-OIG) will be prioritizing audits of pharmacy claims in 2024. This furt…
HLA Wins Network Reinstatement for Illinois Pharmacy
PBMs are increasingly terminating pharmacies for minor infractions of the provider manuals or network enrollment forms. These term…
PBM Audit Response Summary
PBM audits can be resolved successfully, but more frequent and aggressive audits will require careful planning. Providers should a…