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2019 Delaware Code
Title 18 - Insurance Code
Chapter 33A. Pharmacy Benefits Managers [For application of this chapter, see 80 Del. Laws, c. 245, §  2]
Subchapter I Pharmacy Audit Integrity Program [For application of this subchapter, see 80 Del. Laws, c. 245, § 2]
§ 3308A Audit information and reports [For application of this section, see 80 Del. Laws, c. 245, §  2].

Universal Citation:
18 DE Code § 3308A (2019)
Learn more This media-neutral citation is based on the American Association of Law Libraries Universal Citation Guide and is not necessarily the official citation.

(a) A preliminary audit report must be delivered to the pharmacy within 30 days after the conclusion of the audit. The preliminary audit report shall contain claim level information for any discrepancy and an estimated recovery amount.

(b) A pharmacy must be allowed at least 45 days following receipt of the preliminary audit to provide documentation to address any discrepancy found in the audit.

(c) A final audit report must be delivered to the pharmacy within 120 days after receipt of the preliminary audit report or final appeal, whichever is later.

(d) An entity shall remit any money due to a pharmacy or pharmacist as a result of an underpayment of a claim within 45 days after the appeals process has been exhausted and the final audit report has been issued.

80 Del. Laws, c. 65, § 1; 80 Del. Laws, c. 245, § 1.

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