23 CAR § 142-104. Recoupment

If the enrollee is verified to be eligible by the vision care provider through customary verification methods of the insurer, vision benefit manager, vision care plan, or vision care discount plan, and if the healthcare provider relies in good faith on the verification and provides covered services or covered materials to the enrollee, then the insurer, vision benefit manager, vision care plan, or vision care discount plan shall not withhold or recoup payment made to the healthcare provider for the covered service or covered material if the insurer, vision benefit manager, vision care plan, or vision care discount plan later determines the enrollee to have been ineligible on the date of service.