Magazine article Drug Topics

Independent Wins Lawsuit to Gain Access

Magazine article Drug Topics

Independent Wins Lawsuit to Gain Access

Article excerpt

Even in a state with a "freedom-of-access" law, independents may still have to fight to open up a pharmacy network. But they can win.

That's what Robert Lolley found out recently, after winning $25,000 in a lawsuit against a local health maintenance organization, the Matthew Thornton Health Plan, Nashua, N.H. He is also now a member of the network.

Back in 1992, after New Hampshire had passed a freedom-of-access bill in July of that year, Lolley found that his independent pharmacy, Medicine World, Nashua, was still locked out of the Matthew Thornton Health Plan's pharmacy network.

The plan argued that it did not have to open its then-current network until it saw the need to send out a call for new pharmacy contract bids, he claimed. The plan said its current client contracts were locked in place, without a need for additional pharmacy providers. In response, Lolley's pharmacy went ahead and filled prescriptions for several customers in the plan and billed the plan to be reimbursed for 10 claims worth a total of $37.06. …

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