Dr. Toby C. Frost
Toby C. “Chad” Frost, PharmD, JD, CPBS is a pharmacy attorney, healthcare executive, and pharmacy and PBM subject-matter expert with more than twenty years of experience spanning pharmacy operations, executive leadership, PBM contracting, reimbursement, audits, compliance, accreditation readiness, and regulatory matters.
He founded and scaled an independent pharmacy organization from two employees to 42 employees, approximately $12 million in annual revenue, and operations serving patients across seven states. His experience includes PBM and payer contracting, network participation, claims adjudication, audit and recoupment response, pharmacy reimbursement, operational compliance, compounding operations, accreditation preparation, regulatory inspections, organizational growth, and P&L responsibility.
His legal training and scholarship on ERISA preemption, PBM market structure, pharmacy competition, and reimbursement policy strengthen his ability to connect governing frameworks with the operational and economic realities facing pharmacies, payers, healthcare organizations, and their counsel.
Frost is licensed to practice law only in Alabama and is admitted to the United States District Court for the District of Colorado. He is available nationally for consulting and testifying expert engagements conducted through retaining counsel.
Frost Health Law is an independent publication and professional platform. This profile offers expert-witness and litigation-consulting services, not legal representation.
- Drug Abuse
- Health Care Economics
- Health Care Litigation
- HIPAA
- Managed Care & HMOs
- Medical Billing
- Medical Credentialing
- Medical Fraud
- Medical Toxicology
- Pharmacology
- Q: Please list your professional accreditations, degrees, licenses, and certificates granted:
- A: Doctor of Pharmacy (PharmD), University of Tennessee Health Science Center, 2002.
Juris Doctor (JD), Health Law Concentration, University of Tennessee College of Law, 2021.
Alabama Bar License 3672F69Z
Federal Court District of Colorado Admission
Tennessee Pharmacist License No. 12080; active and in good standing.
Certified Pharmacy Benefits Specialist (CPBS), Pharmacy Benefits Institute of America, TransparentRx, and University of Kentucky College of Pharmacy.
APhA Diabetes Educator Certification.
APhA Immunization Certification.
APhA Asthma Certification.
LexisNexis Certification.
USP 795 and 800 compliance training.
ACHC accreditation training. - Q: Please list your affiliations or memberships in any professional and/or industry organizations:
- A: American Bar Association.
American Society for Pharmacy Law.
Tennessee Pharmacists Association.
Phi Alpha Delta Law Fraternity.
Kappa Psi Pharmacy Fraternity. - Q: Please list any teaching or speaking experience you have had, including subject matter:
- A: Adjunct Professor of Clinical Pharmacy, University of Tennessee Health Science Center, 2014 to present. Teaches Advanced Community Pharmacy and Compounding and Regulatory Compliance to PharmD candidates. Subject matter includes USP 795 and 800 compounding standards; regulatory frameworks governing community and compounding pharmacy practice; pharmacist standard of care; and pharmacy law fundamentals.
Continuing education programming available for state pharmacy associations, bar association sections, and industry conferences on ERISA preemption, PBM regulation, and pharmacy law, calibrated to pharmacist or attorney audiences.
Has provided PBM regulatory input to Tennessee policymakers on PBM-related questions. - Q: Have any of your accreditations ever been investigated, suspended or removed? (if yes, explain)
- A: No. Both Alabama Bar License No. 3672F69Z and Tennessee Pharmacist License No. 12080 have been continuously active and in good standing with no disciplinary history. No professional accreditation, license, or certification has been investigated, suspended, or removed.
- Q: On how many occasions have you been retained as an expert?
- A: No prior retained expert engagements. Available as a first-time expert witness with twenty-plus years of pharmacy operations leadership, executive compliance experience, and direct PBM contracting experience supporting substantive expert testimony in pharmacy and PBM matters.
- Q: For what area(s) of expertise have you been retained as an expert?
- A: No prior expert retention to date. Available for retention in the following areas: PBM contracting, network admission, credentialing, and recredentialing; ERISA Section 514 preemption analysis; pharmacy reimbursement methodology, MAC pricing, and spread-pricing analysis; pharmacy compounding compliance under USP 795 and 800; pharmacy standard of care; PSAO selection and pharmacy-payer contract negotiation; DEA and FDA audit defense; State Board of Pharmacy disciplinary proceedings; healthcare antitrust as applied to PBM vertical integration; and False Claims Act and qui tam matters in pharmacy benefits.
- Q: For how many years have you worked with the legal industry as an expert?
- A: No prior retained expert service. The foundation for the proposed opinions is more than twenty years of pharmacy operations, executive leadership, PBM contracting, reimbursement, audit, compliance, accreditation, and regulatory experience, strengthened by legal training and industry-focused scholarship.
- Q: What services do you offer? (E.g.: consulting, testing, reports, site inspections etc.)
- A: Consulting and testifying expert services; case and records analysis; expert reports; deposition and trial testimony; arbitration and administrative-proceeding testimony; PBM contract and provider-manual analysis; PBM audit and recoupment analysis; reimbursement, MAC-pricing, and claims-adjudication analysis; network participation and credentialing analysis; pharmacy operations and standard-of-care assessment; compliance-system and accreditation-readiness assessment; pharmacy-economics analysis; and regulatory-practice analysis.
Services involving litigation are performed through retaining counsel. Engagements may include industry and operational analysis supporting matters involving ERISA preemption, competition, False Claims Act allegations, regulatory compliance, and PBM conduct. Legal opinions concerning the governing law are reserved to the court and retaining counsel.
- Q: What is your hourly rate to consult with an attorney?
- A: $450/hour
- Q: What is your hourly rate to review documents?
- A: $450/hour
- Q: What is your hourly rate to provide deposition testimony?
- A: $650/hour
- Q: What is your hourly rate to provide testimony at trial?
- A: $750/hour
- Q: Please list any fees other than those stated above (E.g.: travel expenses, copy fees, etc.)
- A: Travel time is billed at $225 per hour. Reasonable travel and engagement expenses are billed at actual cost. Deposition testimony carries a four-hour minimum, and trial appearances carry an eight-hour minimum. Testimony fees and estimated expenses are payable in advance. Expedited engagements requiring substantive work within 72 hours are billed at 1.25 times the applicable rate. A $5,000 replenishing retainer is required for substantive engagements; unused amounts are refundable at the conclusion of the engagement
Available Upon Request