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Oregon · Through 2025 Edition

ORS 735.544: Pharmacy claims audits; standards for review of claims.

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Where this section sits in the code
  1. 18 - Financial Institutions, Insurance
  2. 56. Insurance
  3. Chapter 735 — Alternative Insurance

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.

Collected 2026-09-03T23:50:17Z. Source file · JSON

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