Section 760 IAC 5-3-2 - LimitationsAuthority: IC 27-1-24.5-20
Affected: IC 27-1-24.5-22
Sec. 2.
(a) A pharmacy benefit manager may cause an audit to occur at a particular pharmacy location not more than one (1) time per calendar year. However, if the audit results in a finding of material noncompliance at the pharmacy, the pharmacy benefit manager or auditor may return within the calendar year to determine ongoing compliance.(b) An independent auditor that conducts an audit on behalf of a pharmacy benefit manager may conduct an audit at a particular pharmacy location not more than one (1) time per calendar year for each pharmacy benefit manager. However, if the audit results in a finding of material noncompliance at the pharmacy, the auditor may return within the calendar year to determine ongoing compliance.(c) A pharmacy benefit manager may not conduct an audit at a particular pharmacy location and engage an independent auditor to conduct an audit on behalf of the pharmacy benefit manager at the same pharmacy location within the same calendar year. However, if an audit results in a finding of material noncompliance at the pharmacy, the pharmacy benefit manager or auditor may return within the calendar year to determine ongoing compliance.Department of Insurance; 760 IAC 5-3-2; filed 2/23/2023, 9:48 a.m.: 20230322-IR-760220287FRA