FL H0745

Creates section 465.1885, Florida Statutes, establishing pharmacy rights during audits by managed care companies, insurance companies, third-party payors, pharmacy benefit managers, and similar entities.

Requires entities to provide at least 7 calendar days' notice before initial onsite audits and schedule audits after the first 3 calendar days of a month unless the pharmacist consents otherwise.

Limits audit periods to 24 months after claim submission or adjudication and requires clinical/professional judgment audits to be conducted by or in consultation with a pharmacist.

Entitles pharmacies to preliminary audit reports within 120 days, 10 business days to respond to findings, final reports within 6 months, and recoupment based on actual overpayments rather than extrapolation.

Exempts audits involving suspected fraud, federally funded program claims, and concurrent reviews occurring within 3 business days of claim transmission from these protections; also exempts notice requirements for audits of pharmacies in HEAT Task Force areas that have been credentialed for less than 12 months.