Sec. 6. (a) This section does not apply to an audit conducted by the Medicaid, Medicare, or any other federal program.
(b) Following an audit, the auditor shall provide to the pharmacy written audit reports as follows:
(1) The auditor shall deliver a preliminary audit report to the pharmacy not later than ninety (90) days after the audit is concluded.
(2) The auditor shall provide with the preliminary audit report a written appeal procedure for the pharmacy to follow if the pharmacy desires to appeal a finding contained in the preliminary audit report. The written appeal procedure must provide for a period of at least thirty (30) days after the pharmacy receives the preliminary audit report during which the pharmacy may file an appeal of findings contained in the preliminary audit report.
(3) The auditor shall deliver a final audit report to the pharmacy not later than one hundred twenty (120) days after:
(A) the preliminary audit report is received by the pharmacy; or
(B) if an appeal is filed, a final appeal determination is made;
whichever is later.
(4) Each audit report must be signed by the auditor and a pharmacist participating in the audit.
(5) The auditor shall provide a copy of the final audit report to the third party payer.
(c) If requested by the pharmacy, the auditor shall provide the audit report under this section to the pharmacy by a means that allows signature confirmation, including an electronic signature (as defined by IC 25-26-13-2). If the audit report is sent by electronic mail, any other verification system may be used, provided that the receipt is acknowledged by the pharmacy.
As added by P.L.7-2009, SEC.1. Amended by P.L.159-2012, SEC.11.
Structure Indiana Code
Title 25. Professions and Occupations
Article 26. Pharmacists, Pharmacies, Drug Stores
25-26-22-1. Definitions Applicable to Chapter
25-26-22-3. "Extrapolation Audit"
25-26-22-4.2. Third Party Payer Onsite Audit Limitations
25-26-22-5. Audit Requirements
25-26-22-6. Written Audit Reports
25-26-22-7. Clerical Errors; Fraud; Recoupment of Payment
25-26-22-8. Overpayment and Underpayment Audit Findings
25-26-22-9. Audit Report; Distribution; Interest Accrual
25-26-22-10. Prohibition of Extrapolation Audits for Calculating Recoupments or Penalties
25-26-22-11. Application of Chapter for Investigative Audits