The law provides pharmacies the following protection:

● PBMs must provide the pharmacy at least 10 days notice of their intent to audit;

● PBMs must provide the pharmacy at least 7 days notice of the range of prescription numbers that will be subject to audit;

● Recoupment is allowed only if the errors are substantive and not merely typographical or clerical in nature;

● The law limits the practice of extrapolation under most conditions;

● PBMs may not audit claims more than 2 years after they were submitted; and

● The law establishes a written appeals process that clearly defines timelines for appealing audit findings

Link to Existing Law: ORC Title 39 Ch. 3901 Section 3901.811

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.