Appeals process - Dismissal - Fraud or willful misrepresentation - Application of act.

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A. Each entity conducting an audit shall establish a written appeals process under which a pharmacy may appeal an unfavorable preliminary audit report and/or final audit report to the entity.

B. Following an appeal, if the entity finds that an unfavorable audit report or any portion thereof is unsubstantiated, the entity shall dismiss the audit report or the unsubstantiated portion of the audit report without any further action.

C. Any final audit report, following the final audit appeal period, with a finding of fraud or willful misrepresentation shall be referred to the district attorney having proper jurisdiction or the Attorney General for prosecution upon completion of the appeals process.

D. This act does not apply to any audit, review or investigation that is initiated based on or that involves fraud, willful misrepresentation or abuse.

Added by Laws 2008, c. 137, § 4, eff. Nov. 1, 2008. Amended by Laws 2011, c. 375, § 2, eff. Nov. 1, 2011; Laws 2021, c. 409, § 2, emerg. eff. May 4, 2021.


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