Sec. 8. An audit finding of an overpayment or underpayment of a claim:
(1) must be based on an actual overpayment or underpayment; and
(2) may not be based on a projection that is based on the number of:
(A) patients who:
(i) have similar diagnoses; and
(ii) are served by the pharmacy; or
(B) prescriptions for or refills of similar legend drugs that are dispensed by the pharmacy.
As added by P.L.7-2009, SEC.1.
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