HB 5987

Abstract

Creates the Audits of Pharmacy Benefits Act. Imposes a number of requirements on audits of pharmacy services conducted pursuant to a contract entered into by the pharmacy and the auditing entity on behalf of a health carrier or a pharmacy benefits manager. Requires the entity conducting a pharmacy audit to deliver a preliminary audit report to the pharmacy and to give the pharmacy an opportunity to respond to the report prior to issuing a final audit report. Provides that the entity is also required to implement a process for appealing the findings of the final audit report, and further provides that if either party is unsatisfied with the appeal, that party may seek relief under the terms of the contract. Establishes a number of requirements that the auditing entity must follow when calculating the amounts and penalties that are to be recovered from the pharmacy based on the audit report, and prohibits the entity from receiving payment on any basis tied to the amount claimed or recovered from the pharmacy. Effective immediately.