Iowa § 510B.8C Clean claims

Iowa Statutes

§ 510B.8C — Clean claims

Iowa § 510B.8C

Title XIIICOMMERCE

Ch. 510BREGULATION OF PHARMACY BENEFITS MANAGERS

This text of Iowa § 510B.8C (Clean claims) is published on Counsel Stack Legal Research, covering Iowa primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Iowa Code § 510B.8C (2026).

Text

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.

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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.