PBMs must give pharmacies at least 14 business days’ notice before an audit. PBMs must limit the audit to no more than 24 months from the date that the claim was submitted to or adjudicated by the entity. An auditor may not recoup for items not required to be maintained on the face of a prescription. An entity conducting an audit shall utilize the same standards and parameters in auditing a pharmacy the entity uses with other similarly situated pharmacies. An entity conducting an audit shall establish a written appeals process, and may not recoup until the conclusion of the appeal process.

Link to Existing Law: ND Code. Title 19 Ch 19-03.6, section 19-03.6-02

While this is fairly a substantive audit law, there is no provision limiting the number of claims to be audited, and it would be benefited to some degree if it included a statutory private right of action for an aggreived provider. It could also benefit from language prohibiting recoupment when there has not been any financial harm. Finally, the law ennumerates certain dispensing errors that constitute fraud, waste and abuse, including billing for a higher price than the pharmacy’s usual and customary price, or billing for a product without proof of having purchased the product.