Oberheiden P.C. - Pharmacy Claim Reversals

Pharmacy claim reversals can be costly. Not only can they have an immediate impact on pharmacies’ cash flow; but, in many cases, they can lead to additional consequences as well. Pharmacies accused of improperly billing Medicare and Medicaid for medications (and especially those with high reversal rates) can face prepayment review, temporary or permanent loss of eligibility, and other administrative consequences—and, in some cases, improper pharmacy billings can trigger civil or criminal penalties.