North Carolina General Statutes 90-85.52. Pharmacy audit recoupments
(a) 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 N.C. Gen. Stat. § 90-85.51 has elapsed or (ii) after the final internal disposition of an audit, including the appeals process as set forth in N.C. Gen. Stat. § 90-85.51, whichever is later, unless fraud or misrepresentation is reasonably suspected.
(b) Recoupment on an audit shall be refunded to the responsible party as contractually agreed upon by the parties.
(c) 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:
(1) 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.
Terms Used In North Carolina General Statutes 90-85.52
- Contract: A legal written agreement that becomes binding when signed.
- following: when used by way of reference to any section of a statute, shall be construed to mean the section next preceding or next following that in which such reference is made; unless when some other section is expressly designated in such reference. See North Carolina General Statutes 12-3
- Fraud: Intentional deception resulting in injury to another.
(2) 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. (2011-375, s. 1; 2013-379, s. 4.)