2473-S AMH BAIL H5209.1

SHB 2473  - H AMD895
     By Representative Bailey

     Beginning on page 4, line 36, after "(9)" strike all material through "contract." on page 5, line 3, and insert "The covered entity may have the pharmacy benefits manager's books and records audited to the extent the information relates directly or indirectly to the covered entity's contract. The audit must be conducted in accordance with the terms of the pharmacy benefits management services contract between the parties. If the parties have not expressly provided for audit rights and the pharmacy benefits manager has advised the covered entity that other reasonable options are available and subject to negotiation, the covered entity may have the books and records audited as follows:
     (a) Audits may be conducted no more than once in each twelve-month period upon at least thirty business days' written notice to the pharmacy benefits manager;
     (b) The covered entity and the pharmacy benefits manager must mutually select an independent firm to conduct the audit, and the independent firm must sign a confidentiality agreement with the covered entity and the pharmacy benefits manager ensuring that all information obtained during the audit will be treated as confidential. The firm may not use, disclose, or otherwise reveal any information in any manner or form to any person or entity except as otherwise permitted under the confidentiality agreement. The covered entity must treat all information obtained as a result of the audit as confidential, and may not use or disclose the information except as is otherwise permitted under the terms of the contract between the covered entity and the pharmacy benefits manager or if ordered by a court of competent jurisdiction for good cause shown; and
     (c) Audits must be conducted at the pharmacy benefits manager's office where the records are located, during normal business hours, without undue interference with the pharmacy benefits manager's business activities, and in accordance with reasonable audit procedures."

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