HB 349 (BR 1328) - T. Thompson, R. Adams, J. Carney, R. Damron, J. DeCesare, T. Edmonds, D. Floyd, S. Gregory, K. Hall, B. Housman, D. Keene, M. King, B. Montell, T. Moore, F. Nesler, J. Richards, J. Short, F. Steele, W. Stone, D. Watkins, B. Yonts
AN ACT relating to pharmacy audits.
Amend KRS 304.17A-741 to prohibit an auditing entity from requiring a pharmacy to keep records longer than two years or longer than required by state or federal law; prohibit an auditing entity from receiving payment based on the total amount recovered in an audit; prohibit a pharmacy from recoupment of funds by the auditing entity if an audit results in the identification of clerical or recordkeeping errors; grant a pharmacy the right to file amended claims to correct clerical or recordkeeping errors within 30 days if the prescription was dispensed according to state and federal law; permit an auditing entity to seek a refund or recoupment of overpayment limited to the amount paid to the pharmacy minus the amount that should have been paid to the pharmacy, minus dispensing fee; require audit information to be confidential and not shared with other auditing entities; require clean claims to be paid in accordance with 304.17A-702; create a new section of KRS Chapter 205 to subject Medicaid managed care organizations to pharmacy audits conducted by the Department of Insurance; amend KRS 304.17A-745 to conform.
HB 349 - AMENDMENTS
HCS - Retain the original provisions, except allow a pharmacy to be subject to recoupment of funds by the auditor if the wrong medication was dispensed to a patient; limit the recoupment to the amount of the correct medication; require that the audit be shared with the proper enforcement authorities, if there is evidence of fraud; allow the auditor access to previous audits based on a continued relationship with the specific plan.
HFA (1, T. Thompson) - Amend the auditing entity record retention requirement to include federal regulations; delete the provision relating to the confidentiality of audit information, sharing with the appropriate authorities if there is evidence of fraud, and auditing entity access to previous audit records of a pharmacy based on a continued relationship with the specific plan.
Jan 31-introduced in House
Feb 1-to Banking & Insurance (H)
Feb 2-posted in committee
Feb 15-reported favorably, 1st reading, to Consent Calendar with Committee Substitute
Feb 16-2nd reading, to Rules; posted for passage in the Consent Orders of the Day for Wednesday, February 22, 2012
Feb 21-taken from the Consent Orders of the Day, placed in the Regular Orders of the Day
Feb 23-floor amendment (1) filed to Committee Substitute
Feb 24-3rd reading, passed 92-0 with Committee Substitute, floor amendment (1)
Feb 27-received in Senate
Feb 29-to Appropriations & Revenue (S)
Mar 8-reassigned to Health & Welfare (S)
Mar 14-reported favorably, 1st reading, to Consent Calendar
Mar 15-2nd reading, to Rules
Mar 22-posted for passage in the Consent Orders of the Day for Thursday, March 22, 2012; 3rd reading, passed 36-0
Mar 23-received in House; enrolled, signed by each presiding officer; delivered to Governor
Apr 4-signed by Governor (Acts ch. 20)