Pharmacy audits may bypass rules when misconduct is indicated

The subchapter would not apply to an investigative audit of pharmacy records when the review indicates fraud, waste, abuse, or other intentional misconduct. This covers investigative audits of pharmacy records based on physical review, claims data, or statements. The exception applies when fraud, waste, abuse, or other intentional misconduct is indicated. The amendment states that the Act takes effect upon enactment, but it does not give this audit exception a separate start date.

The legislation would apply to contracts between pharmacy benefit managers and pharmacies or pharmacists. This covers contracts entered into, renewed, amended, or extended after the stated waiting period. The Act becomes effective upon enactment. The contract rules apply to contracts entered into, renewed, amended, or extended 6 months after enactment.