PBMs must give pharmacies at least 2 weeks prior to conducting the on-site audit, and the pharmacy may move to reschedule the audit within 7 days. The PBM conducting the audit is prohibited from auditing more than 75 prescriptions per initial audit. They must audit each pharmacy under the same standards and parameters as other similarly situated pharmacies audited by the entity. To the extent that an audit results in the identification of any clerical or record-keeping errors such as typographical errors, scrivener’s errors or computer errors in a required document or record, the pharmacy shall not be subject to recoupment of funds by the PBM unless the PBM can provide proof of intent to commit fraud or such error results in actual financial harm to the PBM. The PBM cannot audit claims that were submitted more than two years prior. PBMs must follow a statutorily-prescribed audit appeal timeline and framework.

Link to Existing Law: 59 OK Stat § 59-356.2

This is a fairly comprehensive fair audit law. It would be benefited to some degree if it included a statutory private right of action for an aggreived provider.