Gov. Josh Green (D) signed into law HB 1643, providing an array of audit protections to pharmacies. Among its provisions, the law requires PBMs to have a registered pharmacist as a consultant when the audit involves clinical judgment.
The law also limits the circumstances for recoupment, requires the same audit standards and parameters as other similarly situated pharmacies that are audited, prohibits audits within the first seven calendar days of the month unless consented by the pharmacy, allows the pharmacy to reverse and rebill within the correction time frame of the audit, and prohibits the use of extrapolation.
NCPA
