Audits of certain contracts. [Effective January 1, 2020.]

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1. Any contract between the Department and a pharmacy benefit manager or health maintenance organization entered into pursuant to NRS 422.4053 must require the pharmacy benefit manager or health maintenance organization, as applicable, to:

(a) Submit to and cooperate with an annual audit by the Department to evaluate the compliance of the pharmacy benefit manager or health maintenance organization with the agreement and generally accepted accounting and business practices. The audit must analyze all claims processed by the pharmacy benefit manager or health maintenance organization pursuant to the agreement.

(b) Obtain from an independent accountant, at the expense of the pharmacy benefit manager or health maintenance organization, as applicable, an annual audit of internal controls to ensure the integrity of financial transactions and claims processing.

2. The Department shall post the results of any audit conducted pursuant to paragraph (a) of subsection 1 on an Internet website maintained by the Department.

(Added to NRS by 2019, 4027, effective January 1, 2020)


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