33-2-2003. Applicability
33-2-2003. Applicability. (1) Except as provided in subsection (2), this part applies to an audit of the records of a pharmacy licensed under Title 37, chapter 7. (2) This part does not apply to an audit of pharmacy records when fraud or other intentional and willful misrepresentation is evidenced by the review of claims data, statements, physical […]
33-2-2004. Audit of pharmacy records
33-2-2004. Audit of pharmacy records. (1) An entity conducting an audit of pharmacy records shall audit a pharmacy using the same standards and parameters as used by the entity in auditing other pharmacies on behalf of the same audit client. (2) An audit that involves clinical or professional judgment must be conducted by or in consultation with […]
33-2-2005. Prohibitions — recoupment — payment — interest
33-2-2005. Prohibitions — recoupment — payment — interest. An entity conducting an audit may not: (1) include dispensing fees unless a prescription was not actually dispensed, the prescriber denied authorization, the prescription dispensed was a dispensing error by the pharmacy, or the identified overpayment is based solely on an extra dispensing fee; (2) recoup funds for prescription clerical […]
33-2-2006. Onsite audits — preliminary and final reports — appeals
33-2-2006. Onsite audits — preliminary and final reports — appeals. For audits conducted onsite, the following provisions apply: (1) An entity that audits a pharmacy shall provide the pharmacy with a preliminary audit report, delivered to the pharmacy or its corporate office of record within 60 days after completion of the audit. (2) A pharmacy has 30 days […]
33-2-1910. Supplemental provisions — rules — exemption
33-2-1910. Supplemental provisions — rules — exemption. (1) The provisions of this part are supplemental to any other provisions of the laws of this state and do not preclude or limit any other powers or duties of the commissioner under the law, including but not limited to Title 33, chapter 2, part 13. (2) The commissioner may […]
33-2-1911. Foreign insurers
33-2-1911. Foreign insurers. (1) A foreign insurer shall, upon the written request of the commissioner, submit to the commissioner an RBC report for the previous calendar year on the later of: (a) the date that an RBC report would be required to be filed by a domestic insurer under 33-2-1903; or (b) 15 days after the request is […]
33-2-1912. Repealed
33-2-1912. Repealed. Sec. 35, Ch. 63, L. 2015. History: En. Sec. 93, Ch. 379, L. 1995.
33-2-1913. Notices
33-2-1913. Notices. All notices by the commissioner to an insurer that may result in regulatory action are effective on dispatch if transmitted by certified mail or, in the case of any other transmission, are effective on the insurer’s receipt of the notice. History: En. Sec. 94, Ch. 379, L. 1995.
33-2-1709. Penalties and liabilities
33-2-1709. Penalties and liabilities. (1) (a) A reinsurance intermediary, insurer, or reinsurer found by the commissioner, after a hearing conducted in accordance with Title 33, chapter 1, part 7, to be in violation of any provision of 33-2-1701 through 33-2-1708: (i) shall, for each separate violation, pay a penalty in an amount not to exceed $5,000; and (ii) is […]
33-2-1901. Short title
33-2-1901. Short title. This part constitutes and may be referred to as “The Risk-Based Capital for Insurers Act”. History: En. Sec. 82, Ch. 379, L. 1995.