The bill amends Section 5-19.1-35 of the General Laws concerning audits of pharmacies by insurers and their intermediaries. Key provisions include the limitation of audits to one on-site audit per pharmacy every twelve 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 without proof of intent to commit fraud. Additionally, the Rhode Island health insurance commissioner is granted the authority to enforce and ensure compliance with these provisions. The act aims to protect pharmacies from excessive audits while maintaining oversight to prevent fraud and abuse. This act would take effect upon passage.

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