Limitations

Act 169 of 2016, § 303, under PHARMACY AUDIT INTEGRITY AND TRANSPARENCY ACT - ENACTMENT.

Act 169 of 2016, § 303

Section 303. Limitations.

(a) General rule.--The provisions of this chapter do not apply to an investigative audit of pharmacy records when:

(1) fraud, waste, abuse or other intentional misconduct is indicated by physical review or review of claims data or statements; or

(2) other investigative methods indicate a pharmacy is or has been engaged in criminal wrongdoing, fraud or other intentional or willful misrepresentation.

(b) Federal law.--This chapter does not supersede any audit requirements established by Federal law.

(c) Scrivener's error.--A scrivener's error made by a pharmacy not attributed to fraud, waste or abuse that is discovered during a pharmacy audit by the PBM shall result in the PBM recouping the dispensing fee for that particular transaction, not the entire amount for the medication received by the patient. ((c) added July 17, 2024, P.L.852, No.77)