2nd Sub.
H.B.
76
PHARMACY AUDIT RIGHTS
Senate Floor
Amendments
Amendment 4 March 7, 2012 10:59 AM
Senator Stephen H. Urquhart proposes the following amendments:
1. Page 14, Line 424 :
424 (b) This section does not apply to an audit of pharmacy records
:
(i)
for a federally funded
2. Page 14, Line 426 through Page 15, Line 429 :
426
{
(i)
}
(A)
the state Medicaid program;
427
{
(ii)
}
(B)
the Medicare Part D program;
428
{
(iii)
}
(C)
a Department of Defense prescription drug program;
{
or
}
429
{
(iv)
}
(D)
a Veteran's Affairs prescription drug program
; or
(ii) when fraud or other intentional and willful misrepresentation is alleged and the pharmacy audit entity has evidence that the pharmacy's actions reasonably indicate fraud
.
3. Page 15, Lines 447 through 451 :
447 (ii) recoup funds for prescription clerical or record keeping errors, including
448 typographical errors, scrivener's errors, and computer errors on a required document or record
449
{
in the absence of any other evidence deemed fraudulent
}
the audit entity has evidence that the
pharmacy's actions reasonably indicate fraud
; or
450 (iii) collect any funds, charge-backs, or penalties until the audit and all appeals are
451 final, unless the
audit
entity has evidence
{
the actions by the pharmacy constituted fraud
}
that
the pharmacy's actions reasonably indicate fraud
.
4. Page 16, Lines 480 through 482 :
480
{
(10) This section does not apply to any audit, review, or investigation that involves
481 probable Medicaid fraud, probable Medicaid abuse, probable insurance fraud, or other criminal
482 fraud or criminal misrepresentation } .
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