Section 58-29E-13 - Certain claims adjustments prohibitedA pharmacy benefit manager may not, directly or indirectly, retroactively adjust a claim for reimbursement submitted by a pharmacy for a prescription drug, unless:
(1) The adjustment is necessitated by a pharmacy audit conducted in accordance with chapter 58-29F;(2) The adjustment is necessitated by a technical billing error;(3) The original claim was found to have been fraudulently submitted; or(4) The claim submission was a duplicate for which the pharmacy had already received payment.SL 2019, ch 213, §2; SL 2023, ch 166, §13.Amended by S.L. 2023, ch. 166,s. 13, eff. 7/1/2023.Added by S.L. 2019, ch. 213,s. 2, eff. 7/1/2019.