AK HB259

Establishes procedures and standards for audits of pharmacy records conducted by insurers, managed care companies, third-party payors, and pharmacy benefits managers in Alaska.

Requires auditors to provide at least two weeks' notice before initial on-site audits and prohibits scheduling audits during the first seven business days of a month; audits of claims must occur within two years of submission.

Mandates that audits involving clinical or professional judgment be conducted by or in consultation with a licensed pharmacist, and prohibits use of extrapolation to calculate overpayments or underpayments.

Requires preliminary audit reports within 60 days of audit completion, allows pharmacies 30 days to respond with documentation, and mandates final reports within 90 days; establishes written appeal processes before chargebacks or recoupments can be assessed.

Prohibits clerical or typographical errors from constituting fraud, prevents auditor compensation based on recovery percentages, and prohibits interest accrual during audit periods; does not apply to criminal investigations or governmental agency investigations.