760 Ind. Admin. Code 5-3-5

Current through October 31, 2024

Section 760 IAC 5-3-5 - Clerical errors; fraud; recoupment of payment

Authority: IC 27-1-24.5-20

Affected: IC 27-1-24.5-22

Sec. 5.

(a) A clerical or record keeping error, such as a typographical error, scrivener's error, or computer error related to or contained in a document that is necessary to the conduct of an audit, does not constitute fraud without proof of intent to commit fraud.

(b) If a clerical error is identified during the course of an audit, the pharmacy must be allowed to obtain a prescription that corrects the clerical error from the prescriber.

(c) A clerical or record keeping error may not result in the recoupment of payment if the patient has received the drug for which the claim was submitted.

760 IAC 5-3-5

Department of Insurance; 760 IAC 5-3-5; filed 2/23/2023, 9:48 a.m.: 20230322-IR-760220287FRA