HB 360 Summary: The Pharmacy Audit Integrity Act

• Establishes minimum and uniform standards for pharmacy record audits conducted by health benefit plans, pharmacy benefit managers, managed care companies, and state health programs.

• Requires auditing entities to provide written notice at least two weeks before audits, use pharmacist consultation for clinical judgments, and prohibit interference with pharmacy operations during audits.

• Prohibits use of extrapolation accounting methods to calculate recoupments or penalties; limits audit periods to two years from claim submission and prohibits audits during the first five calendar days of any month.

• Requires preliminary audit reports within 120 days and final reports within 180 days, with pharmacies allowed 30 days to respond to preliminary findings.

• Establishes a written appeals process for unfavorable audit reports, with unresolved disputes subject to mediation through certified mediators from the Alabama Supreme Court's list.