The bill amends Section 5-19.1-35 of the General Laws concerning audits of pharmacies by insurers and their intermediaries. Key provisions include that a pharmacy shall not be subject to more than one on-site audit in connection with a carrier every twelve (12) months, unless there is an identified problem or fraud or misrepresentation is suspected. The bill clarifies that a document or record required under the Medicaid program does not constitute a willful violation.

Additionally, the Rhode Island health insurance commissioner is granted the authority to enforce and ensure compliance with these audit regulations. The act will take effect upon passage.

Statutes affected:
5248: 5-19.1-35
5248  SUB A: 5-19.1-35