Missouri HB1850 modifies pharmacy benefits manager regulations, including pricing transparency and audit procedures.
Missouri HB1850 modifies provisions relating to pharmacy benefits managers by updating pricing transparency and audit procedures. The bill mandates that pharmacy benefits managers update maximum allowable cost pricing at least every seven days. It also establishes a process for pharmacies to appeal pricing decisions within fourteen days. Audits of pharmacy claims must be conducted on-site and limited to twenty-five prescriptions. Entities conducting audits cannot recoup claims based on documentation errors unless fraud is involved.
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