MS HB471

Reduces the time period for audits of pharmacy claims submitted to pharmacy benefit managers and other entities from two years to 90 days from the date the claim was submitted or adjudicated.

Requires pharmacy contracts to detail audit procedures and auditing entities to provide written notice at least two weeks before conducting initial on-site audits.

Prohibits audits from interfering with pharmacist services, limits audits to 100 randomly selected prescriptions (except for specifically identified problems), and restricts entities to one audit per pharmacy per quarter.

Requires preliminary audit reports within 120 days of audit conclusion and final reports within 180 days, with pharmacies given 30 days to respond to discrepancies.

Takes effect July 1, 2020.