65-16,123. Same; procedural requirements. (a) The entity conducting the audit shall follow the following procedures:
(1) An entity conducting an on-site audit must give the pharmacy at least seven days written notice before conducting an initial audit;
(2) an audit that involves clinical or professional judgment must be conducted by or in consultation with a licensed pharmacist;
(3) the period covered by the audit may not exceed two years from the date that the claim was submitted to or adjudicated by the entity;
(4) the pharmacy may request an extension not to exceed seven days from the date of an originally scheduled on-site audit;
(5) the pharmacy may use the records of a hospital, physician or other authorized practitioner to validate the pharmacy record;
(6) any legal prescription, in compliance with the requirements of the state board of pharmacy, may be used to validate claims in connection with prescriptions, refills or changes in prescriptions;
(7) each pharmacy shall be audited under the same standards and parameters as other similarly situated pharmacies; and
(8) the entity conducting the audit must establish a written appeals process.
(b) The entity conducting the audit shall also comply with the following requirements:
(1) A finding of overpayment or underpayment must be based on the actual overpayment or underpayment and not a projection based on the number of patients served having a similar diagnosis or on the number of similar orders or refills for similar drugs;
(2) the entity conducting the audit shall not use extrapolation in calculating the recoupments or penalties for audits, unless required by state or federal contracts;
(3) the auditing company or agent may not receive payment based on a percentage of the amount recovered, unless required by contracts; and
(4) interest may not accrue during the audit period.
(c) This section shall take effect on and after July 1, 2011.
History: L. 2011, ch. 114, ยง 3; June 9.
Structure Kansas Statutes
Article 16 - Regulation Of Pharmacists
65-1626 Pharmacy act; definitions.
65-1626a Practice of pharmacy defined; persons engaged as pharmacists.
65-1627a Same; jurisdiction of board; petition, who may file; stipulation, order based thereon.
65-1627b Same; direction by board to file petition or to prosecute.
65-1627c Same; form of petition, rules.
65-1627f Same; powers of board; term of suspension, probation or revocation; hearing; orders.
65-1627h Costs of proceedings.
65-1627k Certain records of board of pharmacy confidential; exceptions.
65-1628 Order; judicial review.
65-1629 Inspection of drugs by board; samples; analyses; publication of results.
65-1630 Rules and regulations.
65-1633 Change of mailing address or email address of pharmacist.
65-1634 Responsibility for quality of drugs sold; adulteration or mislabeling unlawful.
65-1636 Sale of drugs limited to pharmacies; violations; exceptions.
65-1637a Institutional drug rooms; supervision and record-keeping; rules and regulations.
65-1637e Compounding of drugs and distribution of compounded drugs; rules and regulations.
65-1638 Sale of drugs and poisons by registered pharmacist.
65-1640 Act not applicable to manufacture or to certain sales of poisons.
65-1641 Display of pharmacist license; when unlawful.
65-1644 Duplicate licenses, registrations and permits; fees.
65-1647 Repeated violations of act or rules and regulations may be enjoined.
65-1650 Regulation of advertising of prescription-only drugs; exceptions and exclusions.
65-1651 Sections part of and supplemental to pharmacy act.
65-1653 References to registered pharmacists deemed to apply to licensed pharmacists.
65-1654 Privileged communications.
65-1658 Civil fines for violations.
65-1668 Utilization of unused medications act; not applicable to certain medications.
65-1670 Same; duties of the board of pharmacy; duties of qualifying center or clinic.
65-1671 Same; criteria for accepting unused medications; dispensing.
65-1672 Same; participation; adult care homes; powers and duties of a qualifying center or clinic.
65-1673 Same; criminal and civil liability under the act.
65-1674 Same; rules and regulations; duties of the board of pharmacy.
65-1675 Same; duties of the secretary of health and environment; records.
65-1677 Collaborative drug therapy management advisory committee; purpose and membership.
65-1680 Epinephrine kits in schools; rules and regulations.
65-1681 Prescription monitoring program act.
65-1684 Same; charges and fees prohibited.
65-1686 Same; another agency as contractor.
65-1687 Same; maintenance of records.
65-1688 Same; act does not create civil liability or duty.
65-1689 Same; advisory committee created; members; terms.
65-1690 Same; advisory committee in cooperation with other entities.
65-1691 Same; board consultation with advisory committee; annual report.
65-1692 Same; rules and regulations.
65-1694 Same; veterinary prescription monitoring program task force; study; members; report.
65-1694a Same; prescription monitoring program fund created.
65-1696 State board of pharmacy; fingerprinting and criminal history.
65-16,103 Same; no cost charged to pharmacies; funding of program.
65-16,104 Same; confidential information; authorized access to data in the log.
65-16,106 Same; rules and regulations.
65-16,121 Pharmacy audit integrity act.
65-16,123 Same; procedural requirements.
65-16,124 Same; audit reports; recoupment and repayment of funds; access to audit information.
65-16,125 Same; final report; availability.
65-16,126 Same; application of the act.
65-16,128 Electronic transmission of prescription orders required, when; exceptions.
65-16,129 Pharmacists authorized to administer drugs, when; exceptions.