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2010 SESSION

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HB 198 Pharmacy contracts; establishes requirements for audit procedures.

Introduced by: R. Lee Ware, Jr. | all patrons    ...    notes | add to my profiles

SUMMARY AS INTRODUCED:

Pharmacy contracts; audits.  Establishes requirements for audit procedures with respect to contracts between a health insurance carrier and its pharmacy benefits administrator, or between a carrier and a participating pharmacy provider or its contracting agent. Requirements address notice of audits, nondiscrimination, use of a licensed pharmacist to assist the auditor, provision of preliminary audit reports, use of extrapolations, charging interest, recovery or setoff for any overpayment or denial of claims, and related matters. Such contracts shall include a claims review process. The measure applies to contracts entered into, amended, extended, or renewed on or after January 1, 2011.


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