RÉSUMÉ DIGEST
ACT 514 (SB 281) 2024 Regular Session Edmonds
Existing law provides for definitions regarding pharmacies and pharmacist claims.
Prior law defined "health insurance issuer". New law retains prior law and expands the
definition to include a pharmacy benefit manager and any person acting on behalf of a
pharmacy benefit manager.
Existing law provides criteria for entities conducting audits of pharmacy records, claim
reviews, and quality assurance reviews.
Prior law authorized entities to conduct investigations involving suspected or alleged fraud,
willful misrepresentation, or abuse. New law retains prior law but requires entities to
conform investigations to rules adopted by the commissioner of insurance.
New law requires the commissioner of insurance to promulgate rules that set forth standards
for policies and procedures governing the performance of pharmacy record audits, claim and
quality assurance reviews, and fraud or willful misrepresentation audits.
Effective August 1, 2024.
(Amends R.S. 22:1852(7) and 1856.1(B)(intro para) and (B)(2)(b) and (G); adds R.S.
22:1856.1(H))


Statutes affected:
SB281 Original: 22:1852(7), 22:1(B), 22:1(B)(2)
SB281 Engrossed: 22:1852(7), 22:1(B), 22:1(B)(2)
SB281 Reengrossed: 22:1852(7), 22:1(B), 22:1(B)(2)
SB281 Enrolled: 22:1852(7), 22:1(B), 22:1(B)(2)
SB281 Act 514: 22:1852(7), 22:1(B), 22:1(B)(2)