Modifies provisions relating to pharmacy benefits managers

The definition of 'Audit' was expanded to explicitly include reviews, investigations, and examinations conducted by a PBM or its representative, clarifying that routine claim verification does not count as an audit unless it leads to financial penalties.

The definition of 'Entity' was narrowed to primarily include managed care/insurance companies and PBMs, removing the specific reference to 'subcontractors' of managed care companies while retaining the PBM subcontractor language.

The notice period for on-site audits was increased from one week to fourteen days, and the notice must now be sent via a trackable method.

A new exception was added allowing PBMs to skip the fourteen-day notice requirement if they have specific evidence or suspicion of fraud or intentional misrepresentation by the pharmacy.

The requirement for clinical audits now explicitly mentions consultation with a pharmacist licensed by the Missouri board of pharmacy.

The bill header and section references were updated to reflect that this is a House Committee Substitute for both HB 1850 and HB 1975, and the new section numbers were changed from 338.840 to 376.394 and 376.399.