Fair Pharmacy Audit Law – CALIFORNIA
CALIFORNIA SUMMARY OF EXISTING LAW
The state’s fair audit law includes requirements such as: a prohibition against chargebacks or recoupment from a pharmacy until the time period for filing an appeal to a final audit report has passed; the pharmacy can present evidence to validate orders for dangerous drugs or devices that are subject to invalidation due to extrapolation; there must be an appeals process under which a pharmacy may appeal an unfavorable preliminary audit report to the entity.
Link to Existing Law: Cal. Bus. & Prof. Code § 4438
PRACTICAL NOTE FOR EXISTING LAW
The state has a prohibition against chargebacks until after the audit period (unless they exceed $30,000), but does not have a prohibition against extrapolation or other limitations/restrictions on PBM auditing practices.