House Bill 349

Actions | Amendments
Last Action signed by Governor (Acts ch. 20)
Title AN ACT relating to pharmacy audits.
Bill Documents Bill
Bill Request Number 1328
Sponsors T. Thompson, R. Adams, J. Carney, B. 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
Summary of Original Version 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.
Index Headings of Original Version Health and Medical Services - Pharmacy audit performed pursuant to provider agreement or contract, requirements for
Insurance - Pharmacy audit performed pursuant to provider agreement or contract, requirements for
Insurance, Health - Pharmacy audit, Medicaid audits by Department of Insurance, subject to
Pharmacists - Audits performed pursuant to provider agreement or contract, requirements for
Public Medical Assistance - Pharmacy audit, Medicaid audits by Department of Insurance, subject to
Medicaid - Pharmacy audit, Medicaid audits by Department of Insurance, subject to
Audits and Auditors - Pharmacy audit performed pursuant to provider agreement or contract, requirements for
Audits and Auditors - Pharmacy audit, Medicaid audits by Department of Insurance, subject to
Proposed Amendments House Committee Substitute 1
House Floor Amendment 1
Votes Vote History

Actions

Top | Amendments
01/31/12
  • introduced in House
02/01/12
  • to Banking & Insurance (H)
02/02/12
  • posted in committee
02/15/12
  • reported favorably, 1st reading, to Consent Calendar with Committee Substitute
02/16/12
  • 2nd reading, to Rules
  • posted for passage in the Consent Orders of the Day for Wednesday, February 22, 2012
02/21/12
  • taken from the Consent Orders of the Day, placed in the Regular Orders of the Day
02/23/12
  • floor amendment (1) filed to Committee Substitute
02/24/12
  • 3rd reading, passed 92-0 with Committee Substitute, floor amendment (1)
02/27/12
  • received in Senate
02/29/12
  • to Appropriations & Revenue (S)
03/08/12
  • reassigned to Health & Welfare (S)
03/14/12
  • reported favorably, 1st reading, to Consent Calendar
03/15/12
  • 2nd reading, to Rules
03/22/12
  • posted for passage in the Consent Orders of the Day for Thursday, March 22, 2012
  • 3rd reading, passed 36-0
03/23/12
  • received in House
  • enrolled, signed by each presiding officer
  • delivered to Governor
04/04/12
  • signed by Governor (Acts ch. 20)

Proposed Amendments

Top | Actions
Amendment House Committee Substitute 1
Summary 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.
Index Headings Health and Medical Services - Pharmacy audit performed pursuant to provider agreement or contract, requirements for
Insurance - Pharmacy audit performed pursuant to provider agreement or contract, requirements for
Insurance, Health - Pharmacy audit, Medicaid audits by Department of Insurance, subject to
Pharmacists - Audits performed pursuant to provider agreement or contract, requirements for
Public Medical Assistance - Pharmacy audit, Medicaid audits by Department of Insurance, subject to
Medicaid - Pharmacy audit, Medicaid audits by Department of Insurance, subject to
Audits and Auditors - Pharmacy audit performed pursuant to provider agreement or contract, requirements for
Audits and Auditors - Pharmacy audit, Medicaid audits by Department of Insurance, subject to

Amendment House Floor Amendment 1
Sponsor T. Thompson
Summary 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.
Index Headings Health and Medical Services - Pharmacy audit performed pursuant to provider agreement or contract, requirements for
Insurance - Pharmacy audit performed pursuant to provider agreement or contract, requirements for
Insurance, Health - Pharmacy audit, Medicaid audits by Department of Insurance, subject to
Pharmacists - Audits performed pursuant to provider agreement or contract, requirements for
Public Medical Assistance - Pharmacy audit, Medicaid audits by Department of Insurance, subject to
Medicaid - Pharmacy audit, Medicaid audits by Department of Insurance, subject to
Audits and Auditors - Pharmacy audit performed pursuant to provider agreement or contract, requirements for
Audits and Auditors - Pharmacy audit, Medicaid audits by Department of Insurance, subject to

Last updated: 1/16/2019 3:37 PM (EST)