Anyone owning or operating a pharmacy in Texas understands that managing a pharmacy involves navigating a complex web of legal issues requiring expert guidance. Pharmacy owners and operators realize the importance of assembling a knowledgeable team to handle all necessary regulatory and business requirements. Whether you are purchasing a pharmacy, adding services, dealing with personnel issues, or facing a PBM audit, it’s essential to have an ally standing with you to help explain critical matters and see that they are resolved in your favor.
Because the rules, regulations, and laws surrounding pharmacy operations are intricate and often difficult to understand, every step needed to establish and manage a pharmacy requires a variety of skill-sets. Whether an individual is buying or selling a pharmacy, facing a PBM audit, negotiating contracts, maintaining doctor-patient relationships, or countering threats of lawsuits, Haque Law has the experience, background, and breadth of knowledge to tackle any legal requirement. We will stand with you through all negotiations and bring each issue to its best possible resolution.
For those new to pharmacy operations, it is easy to become discouraged by the daunting array of state, federal, and local regulations covering almost every aspect of pharmacy management. Regardless of your specific area of interest, you can be sure Haque Law will stand with you to meet every challenge. Our mission is to see that your rights and benefits are fully acknowledged and granted. For questions about our services or to discuss a specific issue, please connect with us.
We provide legal representation and counseling in all major pharmacy-related specialties, including the following:
Legal compliance for retail, compound, specialty, and 340B pharmacies
Pain management pharmacy defense and DEA related concerns
Defending pharmacies against PBM audits
Department of Labor’s Exclusion List
Negotiating contracts with federal (Medicare and Medicaid) as well as non-federal PBM payers
Outsourcing facilities (503B) sterile and non-sterile manufacturing and wholesale license
Managing legal issues connected with buying or selling licensed pharmacies or acquiring or transferring licenses
White-collar criminal defense and government investigations (OIG/FBI)
Laws regulating and controlling physician- and clinic-owned pharmacies are complicated and organization-specific
Private equity investments and management services organization (MSO) contract creation and review
Legal Compliance For Retail, Compound, Specialty, And 340B Pharmacies
Legal and organizational structures may differ for each pharmacy type depending on services offered, drugs provided, pricing arrangements, physician-pharmacy relationships, and operational characteristics. Our team has many years of experience successfully guiding organizations through all stages of pharmacy start-up and management.
Managing Legal Issues Connected With Buying Or Selling Licensed Pharmacies Or Acquiring or Transferring Licenses
Buying and selling pharmacies or acquiring or transferring pharmacy licenses is carefully controlled by federal, state, and local regulations. While every transaction is unique, Haque Law works with each client to validate the terms of all contracts, examine the organization’s P&L and Federal Tax statements, confirm business transactions, and advise our clients on related legal matters. We excel in assisting clients who acquire or divest operating or dormant pharmacies, transfer or acquire new required licenses, or need an appropriate legal organizational structure (LLC, corporation, etc.)
Defending Pharmacies Against PBM Audits
A PBM audit (Payment Benefits Manager audit) can be both time consuming and costly. These audits test a pharmacy’s claims payment processes and pricing accuracy seeking reductions in costing and reimbursements. To preserve the integrity of a pharmacy’s pricing structure, any organization subject to an audit should have an ally in its corner to ensure audit procedures and outcomes are favorable. Our team has extensive experience defending pharmacies against aggressive and intrusive outside audits. Get in touch, if you are facing a PBM audit.
Negotiating Contracts With Federal (Medicare and Medicaid) As Well As Non-Federal PBM Payers
The contract negotiated with federal (Medicare and Medicaid) and non-federal PBM payers establishes a pricing and reimbursement structure for your organization. These contracts include MAC pricing (Maximum Allowable Costs), which fixes your pricing and reimbursement schedules. These arrangements can be a make or break component in your agreements and could dramatically impact your P&L. Our team is skilled in negotiating these and other agreements as well as challenging unfavorable MAC pricing plans.
Often large PBMs will attempt to intimidate or bully individual pharmacies into agreeing to contract concessions. We will be there to represent and defend you against any inappropriate PBM’s ‘strong arm’ tactics.
Laws Regulating And Controlling Physician- And Clinic-Owned Pharmacies Are Complicated and Organization-Specific
These arrangements require in-depth legal experience and knowledge, the kind of expertise available to you at Haque Law. Regulatory compliance involving double disclosures, Stark and anti-kickback laws, and patient notices are components of properly establishing this type of pharmacy. Give Haque Law a call to discuss how we can educate you and your associates on the essential steps needed to ensure your organization satisfies all legal requirements. With the help of Haque Law, you can be confident of regulatory compliance while at the same time ensuring the delivery of the highest possible levels of patient care.
Private Equity Investments And Management Services Organization (MSO) Contract Creation And Review
While some states restrict physician investment in pharmacies, Texas allows such investment so long as the arrangement conforms to Texas Patient Non-Solicitation Law exceptions as enumerated in Texas Occupations Code Ann., Section 102.003. Haque Law is skilled in creating, reviewing, and revising physician pharmacy ownership and investment contracts to ensure compliance with all applicable Texas and Federal laws. We are available to evaluate any arrangement you may be considering and provide guidance concerning regulatory compliance.
Department of Labor’s Exclusion List
Under certain circumstances, companies may be disbarred (placed on an exclusions list) from participating in various government contracts, subcontracts, or financial benefits programs, including participation in Medicare, Medicaid, or other plans. These DOL actions can result in significant financial burdens and operational restrictions. Haque Law attorneys have worked with clients to assist in their removal from the Department of Labor’s exclusion list. We aim to help our clients manage the regulatory landscape to achieve positive outcomes.
White-Collar Criminal Defense and Government Investigations (OIG/FBI)
Haque Law attorneys are available to defend clients against any investigations or legal proceedings carried out by any regulatory or judicial authority. Cases we accept include accusations of organized crime, healthcare, and insurance fraud, embezzlement, racketeering, and other white-collar wrongdoings.
Pain Management Pharmacy Defense And DEA Related Concerns
Based on the circumstances, we strategically partner with carefully selected defense attorneys to assist clients accused of crimes related to illegally dispensing controlled substances. Similarly, we may also join forces with appropriate defense attorneys to defend individuals and organizations accused of similar offenses connected with pain management clinics. Contact our office for consultation and guidance on how we can help.
Outsourcing Facilities (503B) Sterile And Non-Sterile Manufacturing And Wholesale Licensing
Entities wishing to do business as a compounder of sterile drugs must register with the FDA under section 503B of The Food Quality and Securities Act. Non-sterile manufacturing includes compounding of items such as lotions, creams, and powders. Although not necessarily FDA approved, these items must be manufactured using good, ethical manufacturing practices. Further, compounding facilities must be licensed under various categories, such as manufacturer, pharmacy wholesaler, importer/exporter, or re-packagers. Our team has worked with individuals and organizations to secure proper licensing for these and other types of production facilities
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Our firm represents a vast portfolio of clients in the business and healthcare industry. With over 40 years of combined experience, not only do we have in-depth legal knowledge, but we have direct hands-on experience inside the business and healthcare industry as owners and operators of pharmacies, executives of clinics, and managers of micro-hospitals. Our team is dedicated to building long-term personable relationships through long-lasting solutions. We achieve this by taking the time to better understand our clients goals and needs. Our ability to relate to our clients’ needs sets us apart from other law firms.
It’s rare to find a group of attorneys that have both operational and legal experience in the healthcare industry. More importantly, it’s even harder to find a law firm that’s built on long term relationships. It’s our experience and relationships that help us tackle any and all issues that our clients may face making us the best in the business.
It is easy to solve problems. It’s much harder to keep problems away. Our approach to issues and resolutions is what stands us apart from other law firms. Our ability to relate and think outside of the box allows us to put policies, procedures, resolutions and agreements in place to keep our clients compliant.
Your Success Is Ours
We define success by our clients success. Oftentimes, the needs of our clients is to simply establish relationships with others in the industry. Watching our clients’ success grow by the relationships we establish is the core to our success ratio.