Iowa Code § 510B.8C: Clean claims.

After the date of receipt of a clean claim submitted by a pharmacy in a pharmacy network, a pharmacy benefits manager shall not retroactively reduce payment on the claim, either directly or indirectly except in the following circumstances:

1. The claim is found not to be a clean claim during the course of a routine audit.

2. The claim submission was fraudulent.

3. The claim submission was a duplicate submission of a claim for which the pharmacy had already received payment.