Minnesota Administrative Rules

2737.1700 RETROACTIVE ADJUSTMENTS.

Subpart 1.

Contracts.

Minnesota Statutes, section 62W.13, must not be waived or modified by contract.

Subp. 2.

Billing errors.

A claim for a billing error must be documented and the information supporting the claim, if any, must be provided to the pharmacy upon request. A pharmacy benefit manager must allow a pharmacy an opportunity to rebut a billing error claim.

Subp. 3.

Fees not subject to adjustment.

Payment for quality performance metrics included in a prescription drug plan that are based on a pharmacy's quality performance and calculated on prescription count are not retroactive claim adjustments.

Statutory Authority:

L 2019 c 39 s 20

History:

46 SR 809

Published Electronically:

September 21, 2022