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Iowa Code Title XIII. Commerce [Chs. 505-554D] § 510B.8D. Clean claims

Current as of January 01, 2024 | Updated by Findlaw Staff

After the date of receipt of a clean claim submitted by a pharmacy in a pharmacy network, a pharmacy benefits manager shall not retroactively reduce payment on the claim, either directly or indirectly except in the following circumstances:

1. The claim is found not to be a clean claim during the course of a routine audit.

2. The claim submission was fraudulent.

3. The claim submission was a duplicate submission of a claim for which the pharmacy had already received payment.

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Cite this article: FindLaw.com - Iowa Code Title XIII. Commerce [Chs. 505-554D] § 510B.8D. Clean claims - last updated January 01, 2024 | https://codes.findlaw.com/ia/title-xiii-commerce-chs-505-554d/ia-code-sect-510b-8d/

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 before relying on it for your legal needs.

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