A CVS Caremark audit can severely impact your pharmacy's finances and operations. Without the right defense, you may face significant penalties. At Health Law Alliance, we specialize in protecting pharmacies during PBM audits and Fraud, Waste & Abuse investigations. Our experienced legal team helps you stay compliant, reduce risks, and resolve issues quickly.
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Your CVS Caremark Audit Questions—Answered
What documents and data should I gather?
Initially, we’ll need CVS Caremark audit determination letters, audit reports, and potential financial records, such as credit card receipts or remittances. As we formulate technical arguments, additional CVS Caremark documentation may be requested. We will provide specifics on supporting materials.
Do CVS Caremark audits target specific pharmacy types?
PBMs like CVS Caremark often unfairly focus on independent, specialty, and compounding pharmacies versus large chains. But all pharmacy types must contend with aggressive CVS Caremark audits. Having legal advocates levels the playing field.
Will filing CVS Caremark appeals impact my network contracts?
Retaliation for exercising CVS audit appeal rights is prohibited. We incorporate proper legal protections into audit responses and settlements. Maintaining existing CVS Caremark contracts is always a priority.
What recourse exists if advance notice isn't provided?
Lack of proper 30-day written CVS Caremark audit notice violates statute in many states. We leverage penalties around insufficient notice periods into negotiation leverage for your pharmacy.
Can CVS audits impact DIR or BER/GER assessments?
Potentially. Depending on the scope of the CVS Caremark audit and the claims involved, any clawbacks should be reconciled in DIR, or BER/GER performance metrics. Our specialists ensure that any downstream CVS Caremark audit consequences are handled properly in your favor.
What are the costs of legal representation for CVS Caremark audits?
We offer flexible fee arrangements based on the scope of representation required and CVS Caremark audit stage. The earlier we are involved the better, as we can shape and limit CVS Caremark audit scope, making legal representation more effective and less costly.