Florida Senate - 2010                                    SB 2194
       
       
       
       By Senator Peaden
       
       
       
       
       2-01840-10                                            20102194__
    1                        A bill to be entitled                      
    2         An act relating to audits of pharmacy records;
    3         amending s. 465.188, F.S.; revising requirements for
    4         the audit of Medicaid-related pharmacy records;
    5         authorizing third-party payor and third-party
    6         administrator audits of pharmacies; providing that
    7         claims containing certain clerical or recordkeeping
    8         errors are not subject to financial recoupment under
    9         certain circumstances; specifying that certain audit
   10         criteria apply to third-party claims submitted after a
   11         specified date; prohibiting certain accounting
   12         practices used for calculating the recoupment of
   13         claims; prohibiting the audit criteria from requiring
   14         the recoupment of claims except under certain
   15         circumstances; providing procedures for the audit of
   16         third-party payor and third-party administrator
   17         audits; providing an effective date.
   18  
   19  Be It Enacted by the Legislature of the State of Florida:
   20  
   21         Section 1. Section 465.188, Florida Statutes, is amended to
   22  read:
   23         465.188 Medicaid financial audits of pharmacies.—
   24         (1) Notwithstanding any provision of other law, when an
   25  audit of the Medicaid-related, third-party payor, or third-party
   26  administrator records of a pharmacy permittee licensed under
   27  this chapter 465 is conducted, such audit must be conducted as
   28  provided in this section.
   29         (a) The agency or other entity conducting the audit must
   30  give the pharmacist at least 1 week’s prior notice of the
   31  initial audit for each audit cycle.
   32         (b) An audit must be conducted by a pharmacist licensed in
   33  this state.
   34         (c) Any clerical or recordkeeping error, such as a
   35  typographical error, scrivener’s error, or computer error
   36  regarding a document or record required under the third-party
   37  payor, third-party administrator, or Medicaid program does not
   38  constitute a willful violation and, without proof of intent to
   39  commit fraud, is not subject to criminal penalties without proof
   40  of intent to commit fraud. A claim is not subject to financial
   41  recoupment if, except for such a clerical or recordkeeping
   42  error, the claim is an otherwise valid claim.
   43         (d) A pharmacist may use the physician’s record or other
   44  order for drugs or medicinal supplies written or transmitted by
   45  any means of communication for purposes of validating the
   46  pharmacy record with respect to orders or refills of a legend or
   47  narcotic drug.
   48         (e) A finding of an overpayment or underpayment must be
   49  based on the actual overpayment or underpayment and may not be a
   50  projection based on the number of patients served having a
   51  similar diagnosis or on the number of similar orders or refills
   52  for similar drugs.
   53         (f) Each pharmacy shall be audited under the same standards
   54  and parameters.
   55         (g) A pharmacist must be allowed at least 10 days in which
   56  to produce documentation to address any discrepancy found during
   57  an audit.
   58         (h) The period covered by an audit may not exceed 1
   59  calendar year.
   60         (i) An audit may not be scheduled during the first 5 days
   61  of any month due to the high volume of prescriptions filled
   62  during that time.
   63         (j) The audit report must be delivered to the pharmacist
   64  within 90 days after conclusion of the audit. A final audit
   65  report shall be delivered to the pharmacist within 6 months
   66  after receipt of the preliminary audit report or final appeal,
   67  as provided for in subsection (2), whichever is later.
   68         (k) The audit criteria set forth in this section apply
   69  applies only to audits of Medicaid claims submitted for payment
   70  after subsequent to July 11, 2003, and to third-party claims
   71  submitted for payment after July 1, 2009. Notwithstanding any
   72  other provision of in this section, the agency or other entity
   73  conducting the audit shall not use the accounting practice of
   74  extrapolation in calculating penalties or recoupment for
   75  Medicaid, third-party payor, or third-party administrator
   76  audits.
   77         (l) The audit criteria may not subject a claim to financial
   78  recoupment except in those circumstances when recoupment is
   79  required by law.
   80         (2) The Agency for Health Care Administration, in the case
   81  of a Medicaid-related audit, or the third-party payor or third
   82  party administrator contracting with the pharmacy, in the case
   83  of a third-party payor or third-party administrator audit, shall
   84  establish a process under which a pharmacist may obtain a
   85  preliminary review of an audit report and may appeal an
   86  unfavorable audit report without the necessity of obtaining
   87  legal counsel. The preliminary review and appeal may be
   88  conducted by an ad hoc peer review panel, appointed by the
   89  agency, in the case of a Medicaid-related audit, or appointed by
   90  the third-party payor or third-party administrator contracting
   91  with the pharmacy, in the case of a third-party payor or third
   92  party administrator audit, which consists of pharmacists who
   93  maintain an active practice. If, following the preliminary
   94  review, the agency or review panel finds that an unfavorable
   95  audit report is unsubstantiated, the agency, in the case of a
   96  Medicaid-related audit, or the third-party payor or third-party
   97  administrator contracting with the pharmacy, in the case of a
   98  third-party payor or third-party administrator audit, shall
   99  dismiss the audit report without the necessity of any further
  100  proceedings.
  101         (3) This section does not apply to investigative audits
  102  conducted by the Medicaid Fraud Control Unit of the Department
  103  of Legal Affairs.
  104         (4) This section does not apply to any investigative audit
  105  conducted by the Agency for Health Care Administration when the
  106  agency has reliable evidence that the claim that is the subject
  107  of the audit involves fraud, willful misrepresentation, or abuse
  108  under the Medicaid program.
  109         Section 2. This act shall take effect upon becoming a law.