MN HF1236

Establishes a pharmacy audit integrity program to set standards for audits of pharmacy records conducted by pharmacy benefits managers (PBMs) and their representatives.

Requires PBMs to provide pharmacies with 60 days' notice before implementing changes to pharmacy audit contract terms.

Mandates that on-site audits be conducted by or in consultation with a licensed pharmacist, with 14 days' notice required before initial audits and prohibits audits during the first five business days of each month without pharmacy consent.

Restricts audit scope to 24 months from claim submission/adjudication, prohibits extrapolation in calculating recoupments, and bars auditor compensation based on percentage of amounts recovered.

Requires preliminary audit reports within 60 days, gives pharmacies 45 days to respond with documentation, and mandates final reports within 120 days with underpayments remitted within 45 days after appeals are exhausted; exceptions apply to fraud investigations and Minnesota health care program audits.