The state’s fair audit law includes requirements such as: recoupments of any disputed funds must occur after final internal disposition of the audit; the time period for an audit is limited to two years; a pharmacy must be given notice 14 days before an initial on-site audit is conducted; the audit sample size must be appropriate for a statistically reliable sample and the PBM must provide a masked list that provides a prescription number or date range; any recoupment will not be deducted against future remittances until after the appeals process and both parties have received the results of the final audit; and the auditing company or agent may not receive payment based on a percentage of the amount recovered.

Link to Existing Law: MN ST § 62W.09

While this is fairly a substantive audit law, there is no provision limiting the number of claims to be audited or recoupment based on extrapolation. In addition, the law would benefit from language limiting recoupment in instances where there has not been financial harm to the PBM.