Oregon Revised Statutes Chapter 735 § 735.544 — Pharmacy claims audits; standards for review of claims

Pharmacy claims audits; standards for review of claims. An entity’s finding that a claim was incorrectly presented or paid must be based on identified transactions and not based on probability sampling, extrapolation or other means that project an error using the number of patients served who have a similar diagnosis or the number of similar prescriptions or refills for similar drugs. [2013 c.570 §6] Note: See note under 735.530.