Provides relative to audits of pharmacy records
The impact of HB 835 is particularly significant for pharmacies and managed care companies in Louisiana. By amending the existing statutes, it seeks to provide a clear legal framework that governs the auditing processes. Proponents of the bill argue that it offers much-needed protections for pharmacies against excessive and potentially unfair audit practices that could disrupt their operations. By enforcing a standard limitation on the frequency of audits, the bill aims to maintain the integrity of pharmacy operations while safeguarding against unnecessary scrutiny. This can lead to a more stable business environment for pharmacists and pharmacies operating in the state.
House Bill 835 aims to clarify and eliminate existing conflicts in Louisiana law related to the timing of onsite audits conducted by health insurance issuers on pharmacy records. The bill specifies guidelines that dictate the limited timeframe within which audits can occur, particularly stating that health insurers may only perform these audits within a certain period following the payment of claims. This is intended to ensure that pharmacies are treated fairly regarding audits and that audits do not occur more than once a year unless under specified conditions, such as a history of error or illegal activity. The proposed adjustments are applicable only to contracts entered into or renewed after January 1, 2017.
The sentiment surrounding HB 835 appears to be generally supportive among pharmacy stakeholders and representatives. There seems to be a recognition of the need to protect pharmacies from the ramifications of frequent audits, which can be both costly and distracting. However, there may be concerns among some insurance companies or regulatory bodies about ensuring accountability and oversight in the auditing processes. Overall, there is an understanding of the importance of balancing the need for scrutiny in the healthcare system with the operational realities faced by pharmacies.
One notable point of contention around HB 835 is the balance between the rights of pharmacies and the regulatory obligations of health insurers. While pharmacies may welcome the stricter limitations on audit frequencies, insurers might argue that more frequent audits are necessary to prevent fraud and ensure compliance with healthcare regulations. This poses a challenge in legislative discussions, as policymakers must find a suitable compromise that upholds the integrity of the healthcare system while providing fair treatment to pharmacy operators.