§ 4437 Pharmacy Audit Time Limits

• •Pharmacy audits can only look back 24 months from when the claim was sent or processed.
• •If the law says so, they can check longer than 24 months.
• •If the original prescription is needed, they might check further back.

A pharmacy gets audited for a medicine claim from 3 years ago.

The audit can only check the last 24 months unless the law or the original prescription requires looking further back.