Florida S1256 regulates pharmacy audits by pharmacy benefit plans, setting standards for audit procedures, documentation, and recoupment.

Florida S1256 amends pharmacy audit regulations, requiring audits to be based on specific evidence or credible allegations of fraud, waste, or abuse. It mandates uniform audit standards, frequency, and penalty practices for all pharmacies. Audits must not disrupt patient care, be limited to a random sampling of prescriptions, and cannot be conducted during the first seven days of a month without consent. The bill also sets recoupment limits, ensuring recoupment is based on actual overpayments and cannot exceed the dispensing fee unless fraud is proven.

Florida S1256 regulates pharmacy audits by pharmacy benefit plans, setting standards for audit procedures, documentation, and recoupment.

Florida S1256 amends pharmacy audit regulations, requiring audits to be based on specific evidence or credible allegations of fraud, waste, or abuse. It mandates uniform audit standards, frequency, and penalty practices for all pharmacies. Audits must not disrupt patient care, be limited to a random sampling of prescriptions, and cannot be conducted during the first seven days of a month without consent. The bill also sets recoupment limits, ensuring recoupment is based on actual overpayments and cannot exceed the dispensing fee unless fraud is proven.