Tag: Freedom of Information Act

The FOIA Request: An Unlikely Tool for Providers in the Age of Managed Healthcare

Since 1967, the Freedom of Information Act (FOIA) has provided the public the right to request access to records from any federal agency, often described as the law that keeps citizens “in the know” about their government. Managed and overseen by the Office of Information Policy within the U.S. Department of Justice, Federal agencies are required to disclose any information requested under the FOIA, unless it falls under one of nine exemptions which protect interests, including personal privacy, national security, and law enforcement. The FOIA also requires agencies to proactively post online certain categories of information, including frequently requested records.

FOIA requests can be used to keep healthcare and life sciences industry stakeholders informed and can provide strategic advantages, even in the context of disputes between private parties. For example, a pharmacy that has been denied access into a network can use FOIA requests to not only understand why they have been denied network access, but also understand how many other pharmacies it has happened to. While private entities like Pharmacy Benefit Managers (PBMs) may not be willing to disclose this information, it may be easily and legally discernable through a FOIA request to CMS. This information can be used to help support legal claims against a PBM or insurer.

Though FOIA requests can be submitted by virtually anyone, it takes time and effort to submit and follow up on. Many FOIA requests can be rejected on the basis that the requested material is not correctly specified, so it is imperative that the request properly identify the specific information sought. If the request is filed properly and is successful, knowing what to do with this information is the most important part of the process.

Frier Levitt Government Affairs assists healthcare and life sciences industry stakeholders formulate FOIA requests and use the information to help maximize your business interests, including predicting trends and future threats to their bottom line. Contact us today to get started.