North Carolina § 90-85 - 52. Pharmacy audit recoupments.

§ 90-85. 52. Pharmacy audit recoupments.

The entity conducting an audit shall not recoup any disputed funds, charges, or other penalties from a pharmacy until (i) the deadline for initiating the appeals process established pursuant to G.S. 90-85.51 has elapsed or (ii) after the final internal disposition of an audit, including the appeals process as set forth in G.S. 90-85.51, whichever is later, unless fraud or misrepresentation is reasonably suspected. Recoupment on an audit shall be refunded to the responsible party as contractually agreed upon by the parties. The entity conducting the audit may charge or assess the responsible party, directly or indirectly, based on amounts recouped if both of the following conditions are met: The responsible party and the entity conducting the audit have entered into a contract that explicitly states the percentage charge or assessment to the responsible party. A commission or other payment to an agent or employee of the entity conducting the audit is not based, directly or indirectly, on amounts recouped. History (2011-375, s. 1; 2013-379, s. 4.) Editor's Note. - Session Laws 2013-379, s. 6, made the amendment to this section by Session Laws 2013-379, s. 4, which rewrote subsection (a), applicable to audits commencing on or after October 1, 2013. Effect of Amendments. - Session Laws 2013-379, s. 4, effective October 1, 2013, rewrote subsection (a), which read "Recoupments of any disputed funds shall occur only after final internal disposition of an audit, including the appeals process as set forth in G.S. 90-85.51 , unless fraud or misrepresentation is reasonably suspected." For applicability, see Editor's note.