On request, a pharmacy provider must allow staff of the Health
and Human Services Commission, the Texas Office of the Attorney General's
Medicaid Fraud Control Unit, and the U.S. Department of Health and
Human Services, or their designees, immediate access to financial
and other records that pertain to the Medicaid program for review
or audit.
(1) The pharmacy provider must give the staff access
to and a sample of the prescription files of the provider's non-Medicaid
customers to determine the provider's usual and customary price.
(2) The pharmacy provider may remove information that
can be used to identify a particular Medicaid client or non-Medicaid
customer.
(3) The pharmacy provider must cooperate in regular
reviews (general audits and utilization reviews) of the records of
its customers who are Medicaid clients.
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