Senate Bill No. by Senator Edmonds aims to amend existing laws regarding the audits of pharmacy records in Louisiana. The bill expands the definition of "health insurance issuer" to include agents, thereby broadening the scope of entities subject to these regulations. It introduces provisions for conducting audits and other reviews of pharmacy records, while also establishing specific criteria that must be followed during these audits. Notably, the bill removes the requirement for pharmacies to submit prescription copies and additional documentation unrelated to the specific claims under review, thereby easing the burden on pharmacies during audits.

Furthermore, the bill outlines exemptions to pharmacy reviews and mandates that any entity conducting an audit related to suspected fraud must notify the division of insurance fraud prior to the audit. It also empowers the commissioner of insurance to take enforcement actions, including the suspension or revocation of licenses, if violations are found during investigations. These changes are set to take effect on August 1, 2024, and aim to enhance the regulatory framework surrounding pharmacy audits while protecting pharmacies from excessive documentation demands.

Statutes affected:
SB311 Original: 22:1852(7), 22:1(B), 22:1(B)(2)