The bill SB1165 amends section 20-3322 of the Arizona Revised Statutes, focusing on pharmacy benefits and audit procedures. It introduces new provisions that prohibit an auditing entity from retroactively reducing the amount of a claim payment to a pharmacist or pharmacy after the adjudication of a prescription drug claim, except in cases of fraudulent submission, duplicate claims, or errors leading to overpayment. The bill also outlines specific requirements for conducting a wholesale invoice audit, including not auditing claims of another auditing entity, reversing discrepancies if the correct drug quantity is dispensed, and accepting certain documentation as valid proof of drug purchase.

Additionally, the bill allows for the increase of claim payment amounts after adjudication and requires auditing entities to provide supporting documentation to pharmacies within ten business days upon request. The bill makes technical changes and is set to become effective on the general effective date.

Statutes affected:
Introduced Version: 20-3322, 20-3335
Senate Engrossed Version: 20-3322
Chaptered Version: 20-3322