Boesen & Snow Law Successfully Overturns $1,000,000 in PBM Audit Findings for Specialty Pharmacy Client

Boesen and Snow successfully assisted an independent specialty pharmacy appeal the findings of a major PBMs desktop audit. The preliminary audit consisted of over $1,000,000 in discrepancies, most of which the PBM considered unappealable. Boesen and Snow utilized a multifaceted argument to appeal the “unappealable” claims including a unique presentation of prescription documentation, prescriber statements, and application of applicable state law. Ultimately, the PBM agreed with the appeal and reversed over $1,000,000 of discrepant claims.