SB1710 Summary

• Requires all entities providing prescription drug coverage to permit and apply prorated daily cost-sharing rates for prescriptions dispensed as less than 30-day supplies when medically appropriate or for medication synchronization purposes.

• Prohibits entities from denying coverage for chronic illness medications dispensed under a synchronization plan agreed upon by the patient, prescriber, and pharmacist, and prohibits prorating dispensing fees based on days' supply.

• Establishes strict audit standards for pharmacy records including 30-day notice requirements, limits on audit timing and duration (4 hours maximum, 100 prescriptions maximum per initial audit), and one audit per pharmacy annually.

• Requires audits to follow generally accepted accounting principles, prohibits extrapolation in calculating recoupments, mandates pharmacist involvement in clinical audits, and establishes an appeals process where unsubstantiated findings must be dismissed.

• Grants the Department of Insurance authority to enforce provisions and impose financial penalties of at least $1,000 per violation, effective January 1, 2020.