Concierge pharmacy services, including membership programs, same-day delivery, medication synchronization, adherence packaging and dedicated pharmacist access, help independent pharmacies compete on service instead of price. Each feature also has to fit within pharmacy board rules, PBM contracts and federal fraud and abuse law. We advise pharmacies in New York, New Jersey, Pennsylvania and Maryland on designing, launching and operating these services.

Licensing, delivery and shipping

Delivery and mail services must follow the board of pharmacy rules in each state where patients live, which can require nonresident pharmacy licenses, specific packaging and temperature controls, and documented counseling. Delivering controlled substances raises additional DEA and state requirements. We map the licenses and procedures a service needs before it expands.

PBM contracts and insured patients

Network agreements often restrict charging insured patients fees beyond their cost-sharing, require consistent pricing and limit how pharmacies market to plan members. A membership fee or cash-pay program that conflicts with those terms can lead to audits, recoupments or termination. We review the pharmacy's PBM contracts and structure the offering around them.

Fraud and abuse rules

Free delivery, gifts, copay waivers and other perks offered to Medicare or Medicaid patients can raise beneficiary inducement and anti-kickback concerns, and some arrangements fit within specific exceptions while others do not. Relationships with prescribers, practices, telehealth platforms and marketers need the same review. We help pharmacies design incentives and partnerships that stay within the rules.

Patient terms and operations

We draft membership and service terms covering what the fee includes, how insurance is handled, cancellation and refunds, and delivery and privacy practices, and we advise on HIPAA, consumer protection and pricing transparency as the service grows.