Payment by the department for pharmacy claims. Limitations. Investigation of pharmacy - Conn. Gen. Stat. § 17b-265f

Pharmacies may only claim payment for prescriptions dispensed to individuals that have prescription insurance if the prescription coverage is exhausted and the individual otherwise qualifies for Connecticut’s medical assistance program or Medicare Part D.  Pharmacies must reimburse the Department of Social Services for improper paid claims. The department may investigate pharmacies that submit high numbers of improper claims to assess whether the pharmacy’s conduct amounts to fraud or abuse under federal or state law.