HB 1789 Summary

• Clarifies that clerical or recordkeeping errors (typographical, scrivener's, or computer errors) do not constitute fraud but may still be subject to recoupment, and requires proof of intent to commit fraud for criminal penalties.

• Requires recoupment to be based on actual overpayment amounts rather than projections unless the pharmacy agrees to a settlement involving projections.

• Prohibits recoupments based on documentation requirements or professional duties exceeding those prescribed by the Arkansas State Board of Pharmacy, effective for claims submitted on or after January 1, 2012.

• Establishes new subsection (f) requiring full refund of any audit recoupment to the responsible party and prohibiting audit charges or assessments based on recouped amounts, unless explicitly stated in a contract and not tied to agent or employee commissions.

• Specifies that these protections do not apply to audits involving alleged fraud, willful misrepresentation, or abuse, including Medicaid fraud, abuse as defined in statute, or insurance fraud.