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Current as of January 01, 2022 | Updated by FindLaw Staff
(a) When a pharmacy benefits manager conducts an audit of a pharmacy, the pharmacy benefits manager shall base the recoupment of overpayments on the actual overpayment of the claim, except as provided in AS 21.27.915(b).
(b) A pharmacy benefits manager conducting an audit of a pharmacy may not
(1) use extrapolation in calculating recoupments or penalties for audits, unless required by state or federal contracts;
(2) assess a charge-back, recoupment, or other penalty against a pharmacy solely because a prescription is mailed or delivered at the request of a patient; or
(3) receive payment
(A) based on a percentage of the amount recovered; or
(B) for errors that have no actual financial harm to the patient or medical plan.
Cite this article: FindLaw.com - Alaska Statutes Title 21. Insurance § 21.27.920. Recoupment - last updated January 01, 2022 | https://codes.findlaw.com/ak/title-21-insurance/ak-st-sect-21-27-920/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
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