Clean claims.

Iowa Code § 510B.8C, under REGULATION OF PHARMACY BENEFITS MANAGERS.

Iowa Code § 510B.8C

After the date of receipt of a clean claim submitted by a pharmacy in a pharmacy network, a pharmacy benefits manager shall not retroactively reduce payment on the claim, either directly or indirectly except in the following circumstances: 1. The claim is found not to be a clean claim during the course of a routine audit. 2. The claim submission was fraudulent. 3. The claim submission was a duplicate submission of a claim for which the pharmacy had already received payment. 2022 Acts, ch 1113, §10, 16, 23