AK SB217

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

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; prevents repeat audits within 90 days of audits finding no errors.

Limits audit scope to claims submitted within two years; prohibits use of extrapolation methods; requires audits involving clinical judgment be conducted by or with a licensed pharmacist; mandates uniform standards across similarly situated pharmacies.

Restricts overpayment recoupment to actual errors with actual financial harm; allows pharmacies 30 days to provide documentation addressing audit discrepancies; prohibits penalties for routine mail or delivery of prescriptions.

Requires preliminary audit reports within 120 days, establishes written appeal processes, mandates final reports within 90 days of appeal completion, prohibits auditor compensation based on recovery percentage, and protects patient information from marketing use; does not apply to criminal investigations or state Medicaid programs; effective January 1, 2013.