What We Do

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