(a) When a pharmacy benefits manager conducts an audit of a pharmacy, the pharmacy benefits manager shall base the recoupment of overpayments on the actual overpayment of the claim, except as provided in Alaska Stat. § 21.27.915(b).
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Terms Used In Alaska Statutes 21.27.920

  • state: means the State of Alaska unless applied to the different parts of the United States and in the latter case it includes the District of Columbia and the territories. See Alaska Statutes 01.10.060
(b) A pharmacy benefits manager conducting an audit of a pharmacy may not

(1) use extrapolation in calculating recoupments or penalties for audits, unless required by state or federal contracts;
(2) assess a charge-back, recoupment, or other penalty against a pharmacy solely because a prescription is mailed or delivered at the request of a patient; or
(3) receive payment

(A) based on a percentage of the amount recovered; or
(B) for errors that have no actual financial harm to the patient or medical plan.
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