{"data":{"id":"us-tx/tex.-insurance-code-1369.266","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 1369.266","heading":"RECOUPMENT AND INTEREST CHARGED AFTER AUDIT.","body":"(a) If an audit under this subchapter is conducted, the health benefit plan issuer or pharmacy benefit manager:\n(1) may recoup from the pharmacist or pharmacy an amount based only on a final audit report; and\n(2) may not accrue or assess interest on an amount due until the date the pharmacist or pharmacy receives the final audit report under Section 1369.264.\n(b) The limitations on recoupment and interest accrual or assessment under Subsection (a) do not apply to a health benefit plan issuer or pharmacy benefit manager that, after reviewing claims data, written or oral statements of pharmacy staff, wholesalers, or others, or other investigative information, including patient referrals, anonymous reports, or postings on Internet websites, suspects the audited pharmacist or pharmacy committed fraud or made an intentional misrepresentation related to the pharmacy business.\nAdded by Acts 2013, 83rd Leg., R.S., Ch. 915 (H.B. 1358), Sec. 1, eff. September 1, 2013.","path":["INSURANCE CODE","TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES","SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES","CHAPTER 1369. BENEFITS RELATED TO PRESCRIPTION DRUGS AND DEVICES AND RELATED SERVICES","SUBCHAPTER F. AUDITS OF PHARMACISTS AND PHARMACIES"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1369.htm#1369.266","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"f74e2dfda42e61ab511333e4711925c927720031f9b8855340b8adecaf32b04c","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-1369.265","next":"us-tx/tex.-insurance-code-1369.267"},"notice":"GroundRules: Original legal text. Not legal advice."}