BILL NUMBER: AB 627	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Gomez

                        FEBRUARY 24, 2015

   An act to amend Section 4431 of the Business and Professions Code,
relating to audits of pharmacy benefits.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 627, as introduced, Gomez.  Audits of pharmacy benefits.
   Existing law imposes specified requirements on an audit of
pharmacy services provided to beneficiaries of a health benefit plan.
Existing law provides that those requirements do not apply to an
audit conducted because a pharmacy benefit manager, carrier, health
benefit plan sponsor, or other 3rd-party payer has indications that
support a reasonable suspicion that criminal wrongdoing, willful
misrepresentation, fraud, or abuse has occurred, or to an audit
conducted by, or at the direction of, the California State Board of
Pharmacy, the State Department of Health Care Services, the State
Department of Public Health, or the Medicare program.
   This bill would make nonsubstantive changes to that provision.
   Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 4431 of the Business and Professions Code is
amended to read:
   4431.  (a)  Nothing in this   This 
chapter shall  not  apply to an audit conducted because a
pharmacy benefit manager, carrier, health benefit plan sponsor, or
other third-party payer has indications that support a reasonable
suspicion that criminal wrongdoing, willful misrepresentation, fraud,
or abuse has occurred.
   (b)  Nothing in this   This   
chapter shall  not  apply to an audit conducted by, or at
the direction of, the California State Board of Pharmacy, the State
Department of Health Care Services, the State Department of Public
Health, or the Medicare program.