The state’s fair audit law includes requirements such as: recoupment of overpayments must be based on the actual overpayment of the claim and not on a projection based on the number of patients served who have similar diagnoses or on the number of similar orders or refills for similar drugs, and any finding of an overpayment may not include the dispensing fee amount unless certain criteria are met. The law contains a 2 year lookback period and requires pharmacies to be audited on equal terms. The law allows pharmacies to validate prescriptions through a variety of records, including records obtained via electronic methods, fax, phone or written prescription orders, and not necessarily the original hard copy prescription order.

Link to Existing Law: A.R.S. § 20-3322

This law does not include an express prohibition on extrapolation, does not set limits on the number of prescriptions to be reviewed, and does not prohibit financial conflicts of interest in conducting audits.