Fair Pharmacy Audits Act Summary

• Creates minimum and uniform standards for pharmacy audits, effective July 1, 2023, with exceptions for Medicaid audits and fraud investigations.

• Requires auditors to provide 14 days' notice (30 days for wholesale audits) specifying prescription numbers and fill dates, and prohibits audits during the first 7 calendar days of each month.

• Limits audits to 50 prescriptions per calendar year, requires licensed pharmacist involvement for clinical judgments, and prohibits recoupment for clerical errors without proof of fraud intent.

• Establishes appeal process allowing pharmacies 90 days (extendable by 45 days) to respond to preliminary findings, with requirements that auditors deliver final reports within 10 days and prohibits recoupment until appeals are completed.

• Prohibits extrapolation audits that estimate results from sample claims to larger claim groups, and requires identical audit standards across similarly situated pharmacies.