FL H0791

Amends section 465.188, Florida Statutes to extend audit requirements to third-party payor and third-party administrator records in addition to Medicaid-related pharmacy records.

Exempts claims from financial recoupment if they contain only clerical or recordkeeping errors (typographical, scrivener's, or computer errors) and are otherwise valid claims.

Prohibits use of extrapolation accounting practices in calculating penalties or recoupment for all pharmacy audits and requires audit findings to be based on actual overpayments or underpayments.

Requires audits of third-party claims submitted after July 1, 2011 to follow the same standards as Medicaid audits submitted after July 11, 2003.

Establishes review and appeal procedures allowing pharmacists to challenge unfavorable audit reports through an ad hoc peer review panel consisting of practicing pharmacists, without requiring legal counsel.