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I was pleased to speak with TIME’s Alana Semuels about compounded GLP-1 medications, the financial pressures facing independent pharmacies, and the legal issues surrounding compounding.
As I discussed in the article, inadequate PBM reimbursement often leaves pharmacies losing money on prescriptions they dispense. Those pressures are an important part of understanding why more pharmacies are exploring compounding to meet patient needs and keep their doors open.
The article examines competing perspectives on patient access, safety, and regulatory oversight. For pharmacies, it underscores the importance of making compliance central to business decisions as scrutiny of compounded GLP-1s continues.
time.com/article/2026/10/07/…
Dae Y. Lee retweeted
PBMs say they are highly pass-through if you take out:
💸 GPO fees
💸 340B spreads
💸 drugmaker fees
💸 rebate exclusions
💸 effective rate spreads
💸 clawbacks
💸 transaction fees
💸 audit takebacks
💸 prior authorization fees
💸 specialty pharmacy markups
💸 integration fees
Looking forward to connecting with independent pharmacy owners and industry colleagues at the NCPA 2026 Annual Convention in Kansas City, October 3–6!
Lucas Morgan and I will be there to discuss the issues affecting your pharmacy—from PBM audits and network disputes to compounding, regulatory compliance, and pharmacy transactions. We look forward to hearing about your challenges and discussing how we can help protect and grow your business.
Attending? Stop by the Buchanan booth or message me to schedule a time to connect. See you in Kansas City!
#NCPA #IndependentPharmacy #PharmacyLaw #PBM #Buchanan
Pharmacy owners are facing a rapidly changing legal and reimbursement environment.
In our May 2026 Pharmacy Insights Newsletter, the Pharmacy Practice Group covers several developments that pharmacy stakeholders should be watching closely, including:
• Pharmacy change of ownership transactions and why CHOW must be handled correctly
• New Jersey’s Patient and Provider Protection Act targeting PBMs
• Tennessee’s FAIR Rx Act and the continuing escalation of state PBM reform
• DEA investigations and the evolving responsibilities of pharmacists
• No Surprises Act and IDR risks for providers
• Recent media coverage on PBM reform and peptide regulation
Pharmacies that wait until there is an audit finding, termination notice, Board inquiry, DEA visit, or failed CHOW transition are often already behind.
Read the May 2026 Pharmacy Insights Newsletter here:
lnkd.in/eG9s_qCQ
#PharmacyLaw #PBM #IndependentPharmacy #PharmacyCompliance #DEA #HealthcareLaw #PBMReform #PharmacyOwners
TN's FAIR Rx Act may become one of the most closely watched state PBM reform laws in the country. In our latest article, Emily Carey and I explain why this law matters not only for pharmacies but also for plan sponsors and other pharmacy-industry stakeholders.
Read the article here:
bipc.com/tennessees-fair-rx-…
#PBMs #Pharmacies #PBMReform #PharmacyLaw #PharmacyLawyer
The April 2026 Pharmacy Insights Newsletter is out (click the link below)
lnkd.in/eqQBus2J
This issue covers several developments that pharmacy stakeholders and plan sponsors should be watching closely:
• FDA’s latest peptide action and what it really means for compounding pharmacies
• Why “PBM transparency” is not always what plan sponsors think it is
• The continued regulatory scrutiny around peptides and Category 2 substances
• Ohio’s new PBM reform law and what it may signal for other states
• Recent PBM settlement developments and their impact on health plans
• Upcoming pharmacy industry events where Lucas Morgan and I will be speaking or attending
For compounding pharmacies, the peptide issue remains one of the most important regulatory developments to monitor. Opportunity still exists, but the compliance line is getting sharper.
For plan sponsors, the OPM OIG audit of CVS Caremark is another reminder that “pass-through” and “transparent” PBM arrangements should not be accepted at face value. Contracts, claims data, audit rights, rebate treatment, administrative fees, and affiliate arrangements all need to be tested carefully.
And for pharmacies, PBM reform continues to move at the state level, with Ohio’s new law adding to the growing patchwork of PBM licensing, transparency, and operational requirements.
As always, the goal is simple: help pharmacies, plan sponsors, and industry stakeholders understand where the legal and business risks are heading next.
#PBM #PharmacyLaw #CompoundingPharmacy #PlanSponsors #HealthcareLaw #Peptides #PBMReform
Lucas Morgan and I discuss the recent developments in the peptide world. Check out our article here.
bipc.com/what-fda%E2%80%99s-…
#Peptides #FDA #PharmacyLaw #PharmacyLawyer
Glad to contribute to Noah Tong's recent article, "PBM oversight gaps widen as violations persist," published in Modern Healthcare.
#PBMs #PBMReform #FiduciaryDuty #Pharmacies #PharmacyLaw #PharmacyLawyer
modernhealthcare.com/politic…
CVS accused of overbilling feds $600M in scheme. Very troubling findings. The same or more egregious findings can be expected in the commercial sector aka self-funded plans. Take a look at my article.
#PBMs #PBMReform #OIGAudit #PharmacyLaw #PharmacyLawyer
bipc.com/the-illusion-of-pbm…
Glad to share that I will be speaking at Benefits Symposium hosted by Kelly Benefits Strategies on fiduciary duty and PBMs.
#PBMs #PBMReform #FiduciaryDuty #PharmacyLaw
Proud to be quoted in PLANADVISER’s latest piece: Increased Scrutiny of Health Plans Leaves Advisers Racing to Keep Up
The reality is simple, i.e., PBMs are no longer operating in the shadows.
With new transparency requirements coming out of Congress and the Department of Labor, plan sponsors are now firmly in the crosshairs.
What I emphasized in the article and what every employer needs to understand is this:
If you are not actively reviewing your PBM contract, auditing performance, and tightening the gaps, you are exposing your plan to real fiduciary risk and potential litigation.
Plan sponsors need to act accordingly.
Happy to connect with any employers, advisers, or consultants trying to get ahead of this shift.
planadviser.com/exclusives/i…
Special thanks to James Van Bramer!
#PBMs #ERISA #HealthPlans #PlanSponsors #Compliance #PBMReform
Proud to share our latest newsletter focused on where the pharmacy and PBM landscape is heading next.
If you’re a pharmacy owner or a plan sponsor, these are real issues impacting reimbursement, audits, and network participation right now.
Take a look at our Pharmacy Insights Newsletter and Sign up:
connect.bipc.com/cv/c92d3433…
#Pharmacies #PBMs #PBMReform #PharmacyLaw #PharmacyLawyer
New episode on "Pharmacy Law Lowdown" is available on Drug Topics! In this episode, Lucas Morgan and I cover #FTC and #ESI settlement, and the positive impact upon the pharmacy industry.
drugtopics.com/view/pharmacy…
#FTC #ExpressScripts #EverNorth #Cigna #ESI #PBMs #PBMReform
CAA 2026 is going to be a great tool for Plan Sponsors and Independent Pharmacies. Check out my article below.
bipc.com/the-consolidated-ap…
#PlanSponsor #CAA #ConsolidatedAppropriationsAct #PBMReform #PBMs #FiduciaryDuty
Another major win for an independent pharmacy.
Kelly Reynolds and I successfully secured a complete reversal of an OIG-driven retrospective payment review that sought to recoup significant funds from our pharmacy client.
These retrospective reviews are not routine audits. They are aggressive, document-intensive investigations that often look years back and rely heavily on technical interpretations of billing, documentation, and regulatory compliance.
In this case, the review centered on alleged discrepancies that, at first glance, appeared difficult to overcome. But as is often the case, the government’s conclusions did not tell the full story.
We dug into the records.
We challenged the assumptions.
We reframed the narrative.
The result: 100% reversal. No recoupment.
This is exactly why pharmacies should not accept audit findings or payment demands at face value.
If your pharmacy is facing an OIG review, audit, or any form of retrospective payment scrutiny, how you respond in the early stages will dictate the outcome.
We deal with these issues every day.
#OIG #Pharmacies #PharmacyLaw #PharmacyLawyer
Join me, Lucas Morgan and Nicolette Mathey for an upcoming webinar (hosted by ATRIUM24) discussion on the legal and regulatory considerations surrounding peptides including FDA regulatory categories, key compliance risks for pharmacies, and how pharmacies can prepare as this area continues to evolve.
Pharmacies across the country are receiving more questions about peptides from both patients and providers. Understanding the regulatory landscape now is critical as scrutiny in this space continues to increase.
Register here:
us02web.zoom.us/webinar/regi…
#Peptides #Compounding #CompoundingPharmacy #FDA #PharmacyLaw #PharmacyLawyer
MAJOR DEVELOPMENT IN ERISA HEALTH PLAN LITIGATION. SEE MY ARTICLE BELOW.
bipc.com/jp-morgan-erisa-cla…
State Enforcement Against Pharmacy Benefit Managers Intensifies: Lessons from Louisiana and West Virginia bipc.com/state-enforcement-a…
Buchanan Life Sciences Team Secures Seven-Figure FDA User Fee Waiver for Manufacturer bipc.com/buchanan-life-scien…
Pleased to be quoted in a recent Bloomberg Law article discussing the emerging TrumpRx discount platform and the uncertainty it may create for pharmacy reimbursement.
news.bloombergtax.com/employ…
#Pharmacies #DTC #TrumpRx #PBMReform #PBMs #PharmacyLaw




