CODING: Words stricken are deletions; words underlined are additions.
HOUSE AMENDMENT
754-118AX-21 Bill No. HB 1945
Amendment No. ___ (for drafter's use only)
CHAMBER ACTION
Senate House
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11 Representative(s) Brown offered the following:
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13 Amendment (with title amendment)
14 On page 21, between lines 29 and 30, of the bill
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16 insert:
17 Section 26. Medicaid audits of pharmacies.--
18 (1) Notwithstanding any other law, an audit of the
19 Medicaid-related records of a pharmacy licensed under chapter
20 465, Florida Statutes, must be conducted as provided in this
21 section.
22 (a) The agency conducting the audit must give the
23 pharmacist at least 2 weeks' prior notice of the audit.
24 (b) An audit must be conducted by a pharmacist
25 licensed in this state.
26 (c) Any clerical or recordkeeping error, such as a
27 typographical error, scrivener's error, or computer error
28 regarding a document or record required under the Medicaid
29 program does not constitute a willful violation and is not
30 subject to criminal penalties without proof of intent to
31 commit fraud.
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HOUSE AMENDMENT
754-118AX-21 Bill No. HB 1945
Amendment No. ___ (for drafter's use only)
1 (d) A pharmacist may use the physician's record or
2 other order for drugs or medicinal supplies written or
3 transmitted by any means of communication for purposes of
4 validating the pharmacy record with respect to orders or
5 refills of a legend or narcotic drug.
6 (e) A finding of an overpayment or underpayment must
7 be based on the actual overpayment or underpayment and may not
8 be a projection based on the number of patients served having
9 a similar diagnosis or on the number of similar orders or
10 refills for similar drugs.
11 (f) Each pharmacy, regardless of whether the pharmacy
12 is a community pharmacy, an institutional pharmacy, or a
13 special pharmacy, shall be audited under the same standards
14 and parameters.
15 (g) A pharmacist must be allowed at least 10 days in
16 which to produce documentation to address any discrepancy
17 found during an audit.
18 (h) The period covered by an audit may not exceed 1
19 calendar year.
20 (i) An audit may not be scheduled during the first 5
21 days of any month due to the high volume of prescriptions
22 filled during that time.
23 (j) The audit report must be delivered to the
24 pharmacist within 90 days after conclusion of the audit.
25 (2) The Agency for Health Care Administration shall
26 establish a process under which a pharmacist may obtain a
27 preliminary review of an audit report and may appeal an
28 unfavorable audit report without the necessity of obtaining
29 legal counsel. The preliminary review and appeal may be
30 conducted by an ad hoc peer-review panel, appointed by the
31 agency, which consists of pharmacists who maintain an active
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hbd0011 11:12 am 01945-0005-325647
HOUSE AMENDMENT
754-118AX-21 Bill No. HB 1945
Amendment No. ___ (for drafter's use only)
1 practice. If, following the preliminary review, the agency or
2 review panel finds that an unfavorable audit report lacks
3 merit and finds that the pharmacist did not commit intentional
4 fraud, the agency shall dismiss the audit report without the
5 necessity of any further proceedings.
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8 ================ T I T L E A M E N D M E N T ===============
9 And the title is amended as follows:
10 On page 3, line 22,
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12 after the semicolon insert:
13 revising the requirements of auditing Medicaid
14 records of pharmacies;
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