58-29E-7. Audits of manager's books and records.
The covered entity may have the pharmacy benefits manager's books and records related to the rebates or other information described in subdivisions 58-29E-4(1), (2), and (3), to the extent the information relates directly or indirectly to such covered entity's contract, audited in accordance with the terms of the pharmacy benefits management services contract between the parties. However, if the parties have not expressly provided for audit rights and the pharmacy benefits manager has advised the covered entity that other reasonable options are available and subject to negotiation, the covered entity may have such books and records audited as follows:
(1)Such audits may be conducted no more frequently than once in each twelve-month period upon not less than thirty business days' written notice to the pharmacy benefits manager;
(2)The covered entity may select an independent firm to conduct such audit, and such independent firm shall sign a confidentiality agreement with the covered entity and the pharmacy benefits manager ensuring that all information obtained during such audit will be treated as confidential. The firm may not use, disclose, or otherwise reveal any such information in any manner or form to any person or entity except as otherwise permitted under the confidentiality agreement. The covered entity shall treat all information obtained as a result of the audit as confidential, and may not use or disclose such information except as may be otherwise permitted under the terms of the contract between the covered entity and the pharmacy benefits manager or if ordered by a court of competent jurisdiction for good cause shown;
(3)Any such audit shall be conducted at the pharmacy benefits manager's office where such records are located, during normal business hours, without undue interference with the pharmacy benefits manager's business activities, and in accordance with reasonable audit procedures.
Source: SL 2004, ch 311, ยง7.
Structure South Dakota Codified Laws
Chapter 29E - Pharmacy Benefits Management
Section 58-29E-1 - Definition of terms.
Section 58-29E-2 - Pharmacy benefits manager licensed as third party administrator.
Section 58-29E-3 - Manager to perform duties in good faith.
Section 58-29E-5 - Permission of entity required to contact covered individual--Exception.
Section 58-29E-6 - Confidentiality of information--Injunction--Damages.
Section 58-29E-7 - Audits of manager's books and records .
Section 58-29E-8 - Dispensation of substitute prescription drug for prescribed drug.
Section 58-29E-8.1 - Cost-sharing information not to be restricted.
Section 58-29E-9 - Rules--Content.
Section 58-29E-10 - Civil action--Enforcement of chapter--Damages.
Section 58-29E-11 - Application of chapter to certain contracts.
Section 58-29E-13 - Certain claims adjustments prohibited.
Section 58-29E-14 - Adjustment of claim due to error in adjudication permitted.