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.
RCW 48.200.230
Basis of finding of claim.
2014 c 213 s 5
Official source: Washington State Legislature. Reproduced from public-domain Washington statutes; confirm against the official source for the current text. Not legal advice.