Political Advocacy

Why You Should Consider Engaging in Political Advocacy

Political Advocacy: Fighting Goliath without Breaking Your Budget

Businesses need to be politically active. This has never been more important than right now, especially in the pharmacy and health care sectors. Vertical integration among the Fortune 50 companies has created an environment where your business’s competitors are making decisions that affect your ability to survive. The health plans that decide whether your pharmacy or practice is in network literally own and operate (either directly or indirectly) your competition. The health plans and their benefit managers also decide whether you followed the rules or engaged in Fraud, Waste, or Abuse, which can result massive financial penalties and network terminations. In short, your competitors decide if their patients can use your pharmacy or practice, what you get paid for the care you deliver, and whether to pay you for your services or to deny or recoup payment in their sole discretion and regardless of the quality of your care and documentation. Your competitors’ owners hold all the cards and are politically active. You have to insert your business into the discussion and level the field.

Litigation Can Be Slow, Uncertain, and May Cost More Money than You Can Recover

Most of our clients assume the only real pathway to fight for their rights to provide pharmacy or health care services (and receive due compensation) is to file a lawsuit the health plans and PBMs. Many clients ask about Class Actions, having heard stories that PBMs and health plans mistreat everyone in their industry. As a practical matter, however, the health plans and PBMs contracts operate to deter these approaches by making expensive litigation even more unpalatable. For example, your contract may bar class actions or require you to pay your attorney’s fees even if you prevail. The costs of litigation are unaffordable for most small business owners. You can expect to pay an initial deposit of at least $50,000 just to start the process. In the end, the fees to fight in arbitration or court usually end up in the hundreds of thousands. This is money you don’t have, especially after your opponent has suspended payment or terminated you from its networks.

Leveling the Playing Field by Enlisting the Help of your Elected Members of the State/Federal Legislatures and Executive Branch

Often, the only real tool the business owner has (small or large) is requesting help from state and federal agencies and elected officials. Policymakers in both blue and red states claim to be business friendly advocates for the underdog. Our firm’s attorneys and lobbyists have decades of experience leveraging elected and appointed officials to champion our clients’ causes. Lobbying costs less than litigation, and investing small amounts every month can generate results, both for today’s problems and when the unexpected happens down the road. Our firm can advocate for you in any state and in our nation’s capital and develop friends who can jump into your current fight or who will answer the call when the need arises.