§ 58-50-420. Mandatory appeals process.
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§ 58-50-420. Mandatory appeals process.
(a)Each auditing entity shall establish an appeals process under which a pharmacy may appeal an unfavorable preliminary audit report to the auditing entity.
(b)If, following the appeal, the auditing entity finds that an unfavorable audit report or any portion of the unfavorable audit report is unsubstantiated, then the auditing entity shall dismiss the unsubstantiated portion of the audit report without any further proceedings.
(c)Each auditing entity shall provide a copy, if required under contractual terms, of the audit findings to the responsible party or the insurer offering a health benefit plan after completion of any appeals process. (2011-375, s. 1; recodified from N.C. Gen. Stat. 90-85.51 by 2025-69, s. 5.1(a), (b).)