S1256 · Pharmacy Audits

Pharmacy Audits; Revising requirements for audits of licensed pharmacies conducted by or on behalf of pharmacy benefit plans or programs; revising audit procedures, documentation requirements, reporting and appeal requirements, and recoupment limits and procedures; authorizing the Office of Insurance Regulation to investigate complaints of violations, issue cease and desist orders, impose fines and other administrative penalties, order restitution for improper recoupments, prohibit any person or entity from conducting audits for a specified timeframe upon certain findings, and suspend or revoke a pharmacy benefit manager’s registration under certain circumstances, etc.