Fair Pharmacy Audit Law – MONTANA

MONTANA SUMMARY OF EXISTING LAW

An entity conducting an audit of pharmacy records shall audit a pharmacy using the same standards and parameters as used by the entity in auditing other pharmacies on behalf of the same audit client. An entity may not audit prescription records that exceed 275 selected prescriptions. The period covered by the audit may not exceed 24 months from the date that the prescription was submitted to or adjudicated by the entity. The auditing entity must establish an appeals process. The auditing entity must provide 10 days’ advance notice of the audit, along with the range of prescription numbers to be included in the audit.

Link to Existing Law: Mont. Code Ann. Title 33 Ch. 2 Pt. 20 § 33-2-2004

PRACTICAL NOTE FOR EXISTING LAW

This is a fairly basis audit law, without a statutorily-prescribed appeal process. It would be benefited to some degree if it included a statutory private right of action for an aggreived provider and if it contained language prohibiting recoupment when there has not been any financial harm.