N.Y. Comp. Codes R. & Regs. tit. 11 § 459.3

Current through Register Vol. 46, No. 53, December 31, 2024

Section 459.3 - Audit reports and appeals

(a)

(1) A pharmacy benefit manager shall establish a written process for report finalization and appeal of the findings of a preliminary audit report and shall include such written process in every pharmacy contract.

(2) When providing a pharmacy with the preliminary audit report pursuant to Public Health Law section 280-c(2)(g), include within such report all documentation used by the pharmacy benefit manager in justifying its audit findings.

(3) When providing a pharmacy with the final audit report pursuant to Public Health Law section 280-c(2)(k), include a disclosure of the final audit chargeback and methodology by which the audit chargeback will be recovered by the pharmacy benefit manager.

(4) If a pharmacy's reasonable request for an extension of time to address a discrepancy or audit finding as set forth in Public Health Law section 280-c(2)(j) is granted, the pharmacy benefit manager shall be permitted an extension of time in issuing the final audit report that shall be equivalent to the time permitted for the pharmacy's extension.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 459.3

Adopted New York State Register November 27, 2024/Volume XLVI, Issue 48, eff. 11/27/2024