Klein, Hockel, Iezza & Patel PC’s (“KHIP”) client, a self-funded health plan, sued a Pharmacy Benefit Manager (“PBM”) to seek an audit of the plan’s records. The PBM engaged in scorched earth litigation tactics to avoid an audit and refused to resolve the case short of a judgment. Each party filed a motion for summary judgment, the parties produced over 5,000 pages in discovery, and argued several discovery motions. KHIP retained the former general counsel of a large PBM as an expert witness to support the health plan’s claims. The case concerned the PBM’s demand that the health plan release the PBM from any and all claims, in a full settlement agreement and release, before the PBM would release the plan’s own patient-related health data (information like Prior Authorizations) to a new PBM retained to take over the health plan’s contract. During sworn testimony, executives from the PBM admitted they purposefully refused to transfer that data without a settlement agreement and release. Congratulations to Jonathan Allan Klein and Sweta Patel for reaching a resolution on behalf of their client.
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