Ankura offers a cross functional team includes former prosecutors, clinicians as well as financial, reimbursement, and compliance experts who employ the skill sets, experience, and passion necessary to support our clients facing litigation, government enforcement, and compliance challenges related to the payment, delivery, and supply of prescription drugs. Our team of experts have collaborated with our clients to leverage their diverse experience to successfully resolve some of the most challenging disputes, enforcement, and compliance issues in the industry.
Ankura’s experts assist counsel across the entire spectrum of pharmacy benefits, including retail, hospital, and specialty pharmacies; distributors; pharmacy benefit managers; and plan sponsors. Our expertise includes: the quantification of financial exposure through analytic and statistical methods; prescription drug claims submission and payment; pharmacy benefit administration; Medicare Part D compliance; and the preparation of expert and consultative reports shared with prosecutors or used in commercial litigation. We’ve assisted our clients on many False Claim Act, Anti-Kickback Statute, Controlled Substance Act and commercial litigation matters that involved the analysis of billions of pharmacy claims transactions to defend against allegations involving:
Our services include:
Ankura quickly and efficiently helps clients analyze, understand, and resolve complex disputes and issues encountered in the defense and prevention of government investigations, qui tam actions, or compliance initiatives.
We understand the complex environment in which pharmacy companies operate and the related dispute, investigation, and litigation support issues they face. Our team of experts includes pharmacists, data analysts, statisticians, economists, industry management, and payor/PBM experts who work with clients to address their most high-risk areas of disputes and compliance including:
Our team has extensive experience in analyzing these claims and providing testimony, either in a litigation setting through presentations to government investigators. We have a track record of credibility with the government assisting our clients in the successful resolution of investigations.
We help clients navigate the complex regulatory and compliance environment in which they operate, addressing their most high-risk areas of operations and compliance including, diversion, Usual and customary pricing; manufacturer coupon use; promotional gift cards; billing and payment accuracy; narrowing networks; and oversight of downstream entities. Ankura supports client’s needs across all government programs — Medicare, Medicaid, SCHIP, DOD/TRICARE, VA and IHS as well as the continuum of payers and providers in the pharmacy space.
Our services include:
Ankura combines deep industry and regulatory experience with data analytics and clinical and billing expertise to provide clients with best in class service and sustainable solutions. Our depth of experience across the pharmacy supply chain and analyzing billions of pharmacy, wholesaler, PBM, and payor transactions allows us to quickly learn our client’s systems and operations, which corresponds to quickly and efficiently providing synthesized and actionable analysis.
Our experience includes: