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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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…
State PBM Reform in Jeopardy After Mulready
The federal government continues to bring enforcement actions relating to false prior authorizations given the high-priced medicat…
Walgreens Must Face Lawsuit Based on False Prior Authorizations
The federal government continues to bring enforcement actions relating to false prior authorizations given the high-priced medicat…
Federal Investigation for OTC Cards is Expanding
Federal prosecutors are expanding a healthcare fraud investigation, charging New York pharmacy owners and employees for violations…
Federal Prosecutors Drop Criminal Charges Against Specialty Pharmacy Owner Relating to False Prior Authorizations
Federal prosecutors have decided not to prosecute the CEO of a Florida specialty pharmacy, represented by Health Law Alliance's An…
Health Law Alliance Recovers More than $20M Unlawfully Seized from Clients by Financial Institutions
Health Law Alliance, with Anthony Mahajan at the helm, recovers $20M+ unlawfully seized by financial institutions, highlighting po…
Novo Nordisk’s Recent Lawsuits to Stop Semaglutide Compounding are Baseless
Anthony Mahajan, an attorney at Health Law Alliance, contends that Novo Nordisk's recent lawsuits against Florida compounding phar…