(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 AS 21.27.915(b). (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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