What We Do
We know the PBM industry. Our decades of experience allow us to effectively assist and advocate for our clients, building lasting relationships with our clients.
We guide PBMs, third party administrators, plans, coalitions, pharmacies, manufacturers, aggregators, utilization review organizations, and other industry players nationwide through complex legal and regulatory issues, using our deep industry knowledge and emphasis on your business strategies to develop uniquely tailored solutions.
Our services include:
COMPLIANCE COUNSELING
- Fraud, Waste, and Abuse
- HIPAA/HITECH
- Patient Privacy
- Medicare Part D
- Dual Eligible Programs
- Prompt Pay
- Any Willing Provider
- Pharmacy Operations
- Clinical Programs
- Provider Contracting
- Discount Card Programs
- 340B Programs
CONTRACTING
- PBM Service Agreements
- Business Associate Agreements
- Pharmacy Network Agreements
- Rebate Agreements
- Data Use/Sales Agreements
- Software License Agreements
- Vendor Agreements
- Contract Drafting, Review, Redlining, Negotiation
- Contract Dispute Resolution
LICENSING & REPORTING
- PBM
- TPA
- UR
- PPO
- Pharmacy
- DMPO
- APCD
- Producer
- PSAO
- Assessments of Licenses Needed
- Initial Applications
- Renewals
- Reports
- Notices of Change
MERGERS & ACQUISITIONS
- PBM, Health Plan, Pharmacy, Discount Card
- Regulatory Due Diligence
- Licensure
- Notices of Change
- Change of Ownership
- Integration Assistance
Government & Third Party Document & Information Requests
- Data Calls
- Market Conduct Exams
- Investigations
- Enforcement Actions
- Reporting/Disclosures
- Subpoenas
- Civil Investigative Demands
- Studies
DAY-TO-DAY OPERATIONs
- Pharmacy Audits
- Pharmacy Terminations
- Reimbursement Issues/Appeals
- Policies and Procedures
- New Programs