510B.8C Clean claims. After the date of receipt of a clean claim submitted by a pharmacy in a pharmacy network, a pharmacy benefits manager shall not retroactively reduce payment on the claim, eitherdirectly or indirectly except in the following circumstances: 1. The claim is found not to be a clean claim during the course of a routine audit.2. The claim submission was fraudulent.3. The claim submission was a duplicate submission of a claim for which the pharmacy had already received payment. 2022 Acts, ch 1113, §10, 16, 23Section applies to pharmacy benefits managers that manage a prescription drug benefit in the state on or after June 13, 2022; 2022 Acts, ch 1113, §16 Sat Dec 23 00:42:29 2023 Iowa Code 2024, Section 510B.8C (3, 0)
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