Connecticut Medical Assistance Pharmacy Program Drug Utilization Review (DUR) Program DUR Board Meeting
|
|
- Ralf McBride
- 5 years ago
- Views:
Transcription
1 March 2015 Minutes ATTENDEES Board Members Present: Kenneth Fisher, R.Ph. (Chair), Keith Lyke R.Ph., Bhupesh Mangla, MD, Richard Gannon, Pharm.D., Charles Caley Pharm.D. BCPP, Ram Illindala, MD, Carol Drufva R.Ph. Ex-Officio Non-Voting Member Present: Heather Kissinger, Pharm. D. (HID), James Zakszewski, R.Ph. (DSS), Herman Kranc, R.Ph. (DSS), Jason Young, Pharm.D. (HP) Guests: Gillian Stephens (Astra Zeneca), David Putelo (ViiV), Janice Pertoso (Alkermes) INTRODUCTORY BUSINESS Ken Fisher called the meeting to order at 6:42 p.m. It was announced that Herman Kranc is the DSS pharmacy manager. A. Previous Meeting Minutes The December 2014 DUR meeting were approved with no changes. B. Follow-Up from Previous Meeting The Board reviewed section 3 titled Follow-up from the December Follow-up 1, a request was made to know whether pregabalin use exacerbates congestive heart failure from a blood volume aspect. Heather Kissinger stated that pregabalin induced CHF seems to be caused by an increase in fluid retention that can be attributed to the inhibition of L type calcium channels. Follow-up 2, a request was made to create an informational alert at the point of sale stating that buprenorphine dosages higher than 24 mg daily have not been demonstrated to provide a clinical advantage. Heather stated that this alert is set to post and pay if a patient is receiving > 24mg/day of buprenorphine. Follow-up 3, a request was made to have query results for the following: Recipients who received controlled substances from 5 or more prescribers in a 30 day period Recipients who received controlled substances from 5 or more prescribers in a 60 day period Recipients who received controlled substances from 5 or more pharmacies in a 30 day period Recipients who received controlled substances from 5 or more pharmacies in a 60 day period Recipients who received any controlled substance prescription with a concurrent diagnosis of poisoning in the past 180 days. 1
2 March 2015 Minutes Heather reviewed the results of the queries with the Board and noted that these query requests stemmed from possible new pharmacy restriction criteria being developed for the Connecticut Medicaid Program. Heather requested to know if the DUR Board was interested in developing additional pharmacy restriction criteria based on the results of the requested queries. Ram Illindala requested to know if a patient s dose of a controlled substance was reduced after the poisoning event, would the criteria still hit. Heather stated that it would but the pharmacist reviewing the individual patient profiles would take a dosing reduction into consideration post poisoning when deciding to send an alert letter. Ram suggested requiring two poisoning diagnoses to be required for the criteria to identify patients. Heather stated that patients will often have multiple poisoning diagnoses on the same date of service, especially if the poisoning was due to a combination of medications. Rich Gannon asked if the criteria could be further targeted to identify patients receiving controlled substances from 5 or more prescribers. Heather stated that the pharmacist reviewing the individual profiles does include a prescriber count for controlled substances. Jim Zakszewski stated that if the Board wanted to approve this criteria for use, the Department of Social Services legal department would have to review and approve also. Jim requested that a reference to the Prescription Monitoring Program (PMP) be placed in the alert message of the criteria and that the word poisoning be underlined. Keith requested to know if all prescribers are required to enroll in the PMP. Ram stated that all prescribers of controlled substances are required to enroll. Herman added that prescribers are also required to report all controlled substances they write for. Rich added that patients who may be paying cash for controlled substances can be identified by utilizing the PMP. The Board requested that the controlled substance use with a concurrent diagnosis of poisoning within the past 180 days be added as an additional pharmacy restriction criteria. Heather stated that once the requested modifications were made to the alert message and letter type, she would send the documents to Jim, who would request the legal department s approval. Follow-up 4, a request was made to have the 2015 DUR meeting dates sent to the DUR members after the meeting. Heather stated that this request was completed. C. Criteria Trend Summary Heather discussed the criteria trend analyses tables included in the DUR Board meeting packet. The tables list the number of criteria exceptions found before and after DUR intervention letters are mailed. Criteria are suppressed for patients who are selected for intervention for 6 months after letters are mailed so that prescribers do not receive the same letter for the 2
3 March 2015 Minutes same patient month after month. In almost all cases the number of criteria exceptions noted 7 months after DUR letters were mailed was reduced as compared to the number of exceptions prior to letters being mailed. D. Program Summary Review The Board reviewed the program summary for 4 th quarter Heather stated that compared to the 3 rd QTR 2014 prescription claims cost increased by approximately $11 million, the number of prescriptions increased by approximately 50,000, the number of unique recipients receiving a prescription increased by approximately 13,000 and the average paid per prescription increased by about $13 during 4 th QTR Heather stated that the program summary from 4 th QTR 2010 was also included in the program summary review to show the Board that the Average paid per unique recipient per month has increased by approximately $115 and the average paid per prescription has nearly doubled in the past 5 years, all while the number of prescriptions and total number of unique recipients has stayed about the same. Also included in the program summary was a bar graph depicting CT average paid per recipient/month and average paid per RX/month compared with two other states in New England. Both the average paid per recipient/month and the average paid per RX/month were more than double what the other two states in the comparison group were reporting. Jim stated that Connecticut is required to cover medications that bring in Federal Rebate dollars, which could explain why there is such a difference in the comparative paid per recipient and RX amounts. E. Intervention Activity Report Heather reviewed the Intervention Activity Report included in the DUR Board packet. It was stated that the Intervention Activity Report is a monthly summary of the distribution of letters mailed to prescribers and also summarizes the main criteria that were reviewed each month. In October 2014, 2,835 profiles were reviewed and 2,640 letters were sent. The main intervention reviewed for the adult population was: ACEI may cause cough (649 letters) Lock-in criteria (658 letters) The main intervention reviewed for the pediatric population was: Underutilization of antimania medications, antidepressants, atypical antipsychotics, and long acting ADHD medications (161 letters) In November 2014, 2,843 profiles were reviewed and 3,506 letters were sent. The main intervention reviewed for the adult population was: Atypical Antipsychotics may exacerbate pre-existing diabetes (1359 letters) Lock-in criteria (654 letters) 3
4 March 2015 Minutes The main intervention reviewed for the pediatric population was: Antibiotic Utilization during the first year of life (1073 letters) In December 2014, 2,833 profiles were reviewed and 2,939 letters were sent. The main intervention reviewed for the adult population was: Overutilization of Narcotics and Therapeutic Duplication of Long Acting Opiates (318 letters) Lock-in criteria (893 letters) The main intervention reviewed for the pediatric population was: Guanfacine used concurrently with CNS depressants (542 letters) F. RetroDUR Criteria New Criteria The following criteria as written in the DUR Board packet were approved by the DUR Board 1. Vorapaxar / Overutilization 2. Vorapaxar / Therapeutic Appropriateness (Black Box Warning) 3. Vorapaxar / Other Antiplatelet Agents Negating 4. Vorapaxar / Other Antiplatelet Agents Negating 5. Vorapaxar / Anticoagulants 6. Vorapaxar / Agents Affecting Hemostasis 7. Vorapaxar / Strong CYP3A4 Inhibitors 8. Vorapaxar / Strong CYP3A4 Inducers 9. Vorapaxar / Hepatic Impairment 10. Vorapaxar / Non-adherence 11. Vorapaxar / Therapeutic Appropriateness 12. Umeclidinium-Vilanterol/ Overutilization 13. Umeclidinium-Vilanterol/ Black Box Warning 14. Umeclidinium-Vilanterol/ Cardiovascular, Convulsive Disorders, Thyrotoxicosis & Diabetes 15. Umeclidinium-Vilanterol / Strong CYP3A4 Inhibitors 16. Umeclidinium-Vilanterol / MAOIs, TCA & Other QT Prolong Meds *Charlie requested to know if this criteria was due to a class warning or if the list of drugs associated with the criteria came directly from the Anoro Ellipta prescribing information. Heather stated that she would follow-up in June. 17. Umeclidinium-Vilanterol / Non-Potassium Sparing Diuretics 18. Umeclidinium-Vilanterol / Nonselective Beta Blockers 19. Umeclidinium-Vilanterol / Anticholinergics 20. Umeclidinium-Vilanterol / Narrow Angle Glaucoma 21. Umeclidinium-Vilanterol / Urinary Retention 22. Fluticasone-Vilanterol / Overutilization 4
5 March 2015 Minutes 23. Fluticasone-Vilanterol / Black Box Warning 24. Fluticasone-Vilanterol / Cardiovascular, Convulsive Disorders, Thyrotoxicosis & Diabetes 25. Fluticasone-Vilanterol / Strong CYP3A4 Inhibitors 26. Fluticasone-Vilanterol / MAOIs, TCA & Other QT Prolong Meds 27. Fluticasone-Vilanterol / Non-Potassium Sparing Diuretics 28. Fluticasone-Vilanterol / Nonselective Beta Blockers 29. Dapagliflozin/Metformin / Overutilization 30. Dapagliflozin/Metformin / CKD Stage 3, 4 & 5 & ESRD 31. Dapagliflozin/Metformin / Therapeutic Appropriateness 32. Dapagliflozin/Metformin / Insulin & Insulin Secretagogues 33. Dapagliflozin/Metformin / Hypotension 34. Dapagliflozin/Metformin / Loop diuretics 35. Dapagliflozin / Nonadherence 36. Dapagliflozin/Metformin / LDL-C Increases 37. Dapagliflozin/Metformin / Bladder Cancer 38. Beclomethasone 40 mcg / Overutilization 39. Beclomethasone 40 mcg / Therapeutic Appropriateness 0-3 yoa 40. Amphetamine Sulfate / Overutilization 41. Amphetamine Sulfate / Overutilization Heather stated that criteria 40 and 41 were for new drug Evekeo, an amphetamine product indicated for the treatment of narcolepsy, obesity, and ADHD. Charlie stated that Vyvanse was recently approved to treat moderate to severe binge eating disorder in adult patients. He has already seen clinicians use this as treatment for binge eating associated with atypical antipsychotic treatment regimens. Charlie stated Prozac is the only other psychotropic medication that has an indication for an eating disorder. Jason Young stated that Evekeo to treat obesity would not be covered under Medicaid. Jim requested to know that if a claim came in for Evekeo and the patient had a diagnosis of narcolepsy and obesity, would the claim deny. Jason stated that the claim would pay because the patient has an approved diagnosis for treatment (narcolepsy), covered under the Medicaid benefit. The covered diagnoses are inherited through class for new drugs. The diagnosis of obesity would not negate the claim from paying because the patient has a valid diagnosis to use Evekeo. G. Top 50 Pharmacies and Prescribers of Controlled Substances The Board reviewed the top 50 pharmacies and prescribers of controlled substances report for 4 th QTR Charlie requested to know if poisoning diagnoses could be mapped to patients who received controlled substances from some of the top prescribers on the list. 5
6 March 2015 Minutes Heather stated she would request if this type of query could be run but suggested that benzodiazepines be added back to the top 50 pharmacies and prescribers reports since many drug poisonings are associated with this class of medications or combinations of opioids and benzodiazepines. Rich agreed that it would be beneficial to add BZDs back to the report and include them in the potential mapping query. Jim requested a cut off age of 70 for the mapping query. Heather stated she would follow-up during the June DUR meeting. H. Newsletter Heather stated an updated version of the March DUR newsletter had been included in the DUR packets. The Board approved the March 2015 Newsletter with minor changes. New Business Heather requested that the September DUR meeting date be moved to August. The Board approved the request and agreed on Wednesday August 26, The remainder of the 2015 DUR meeting dates were confirmed as o Wednesday June 10 th o Wednesday August 26 th o Wednesday December 9 th Heather stated the first draft of the CMS report would be sent to the DUR members on or before May 13 th (one month prior to the June meeting). The meeting was adjourned at 8:35 pm. 6
Connecticut Medical Assistance Pharmacy Program Drug Utilization Review (DUR) Program DUR Board Meeting
September 2018 Minutes ATTENDEES Board Members Present: Kenneth Fisher, R.Ph. (Chair), Keith Lyke, R.Ph., Bhupesh Mangla, MD, Richard Gannon, Pharm.D., Ram Illindala, MD, Dennis Chapron, Pharm.D. Ex Officio
More informationConnecticut Medical Assistance Pharmacy Program Drug Utilization Review (DUR) Program DUR Board Meeting
December 2012 Minutes ATTENDEES Board Members Present: Kenneth Fisher, R.Ph. (Chair), Keith Lyke R.Ph., Dennis Chapron, M.S., Bhupesh Mangla, M.D., Charles Caley, Pharm.D., Ram Illindala, M.D., Richard
More informationConnecticut Medical Assistance Pharmacy Program Drug Utilization Review (DUR) Program DUR Board Meeting
March 2018 Minutes ATTENDEES Board Members Present: Kenneth Fisher, R.Ph. (Chair), Keith Lyke, R.Ph., Bhupesh Mangla, MD, Richard Gannon, Pharm.D., Ram Illindala, MD, Dennis Chapron, PharmD., Carol Drufva,
More informationConnecticut Medical Assistance Pharmacy Program Drug Utilization Review (DUR) Program DUR Board Meeting
March 2011 Minutes ATTENDEES Board Members Present: Kenneth Fisher, R.Ph. (Chair), Keith Lyke R.Ph., Dennis Chapron, M.S., Richard Gannon, Pharm.D., Bhupesh Mangla, M.D., Ram Illindala, M.D., Charles Caley,
More informationConnecticut Medical Assistance Pharmacy Program Drug Utilization Review (DUR) Program DUR Board Meeting
September 2008 Minutes ATTENDEES Board Members Present: Kenneth Fisher, R.Ph. (Chair); Dennis Chapron, M.S.; Richard Gannon, Pharm.D.; Keith Lyke R.Ph., Mike Moore, R.Ph., MPH; Bhupesh Mangla, M.D., Ram
More informationConnecticut Medical Assistance Pharmacy Program Drug Utilization Review (DUR) Program DUR Board Meeting
ATTENDEES Board Members Present: Kenneth Fisher, R.Ph. (Chair), Keith Lyke R.Ph., Dennis Chapron, M.S., Bhupesh Mangla, M.D., Ram Illindala, M.D., Richard Gannon, Pharm.D., Carol Drufva R.Ph., Angela Moemeka,
More informationConnecticut Medical Assistance Pharmacy Program Drug Utilization Review (DUR) Program DUR Board Meeting
June 2008 Minutes ATTENDEES Board Members Present: Kenneth Fisher, R.Ph. (Chair); Dennis Chapron, M.S.; Richard Gannon, Pharm.D.; Keith Lyke R.Ph., Mike Moore, R.Ph., MPH; Bhupesh Mangla, M.D., Ram Illindala,
More informationConnecticut Medical Assistance Pharmacy Program Drug Utilization Review (DUR) Program DUR Board Meeting
ATTENDEES Board Members Present: Kenneth Fisher, R.Ph. (Chair), Keith Lyke R.Ph., Dennis Chapron, M.S., Richard Gannon, Pharm.D., Bhupesh Mangla, M.D., Ram Illindala, M.D., Charles Caley, Pharm. D., Angela
More informationConnecticut Medical Assistance Pharmacy Program Drug Utilization Review (DUR) Program DUR Board Meeting
December 2011 Minutes ATTENDEES Board Members Present: Kenneth Fisher, R.Ph. (Chair), Keith Lyke R.Ph., Dennis Chapron, M.S., Richard Gannon, Pharm.D., Bhupesh Mangla, M.D., Ram Illindala, M.D., Angela
More informationCONNECTICUT MEDICAL ASSISTANCE DUR BOARD MEETING MINUTES SUMMARY CMS FFY 2003
CONNECTICUT MEDICAL ASSISTANCE DUR BOARD MEETING MINUTES SUMMARY CMS FFY 2003 DUR BOARD MEMBERSHIP 10/01/2002 to 09/30/2003 Kenneth Fisher, R.Ph. (Chair), Dennis Chapron, M.S., R.Ph., Richard Gannon, PharmD.,
More informationIdaho DUR Board Meeting Minutes
Date: July 16, 2015 Time: 9am-1:30pm Idaho DUR Board Meeting Minutes Location: Idaho Medicaid, 3232 Elder Street, Boise, Idaho, Conference Room D-West Moderator: Mark Turner, M.D. Committee Member Present:
More informationIdaho DUR Board Meeting Minutes
Idaho DUR Board Meeting Minutes Date: July 20, 2017 Time: 9am-12:30pm Location: Holiday Inn Boise Airport 2970 West Elder Street, Boise, Idaho, 83705 Moderator: David Agler, M.D. Committee Member Present:
More informationIdaho DUR Board Meeting Minutes
Idaho DUR Board Meeting Minutes Date: January 21, 2016 Time: 9am-1:30pm Location: Idaho Medicaid, 3232 Elder Street, Boise, Idaho, Conference Room D-West Moderator: Mark Turner, M.D. Committee Members
More informationIdaho DUR Board Meeting Minutes
Idaho DUR Board Meeting Minutes Date: Jan. 16, 2014 Time: 9am-1pm Location: Idaho Medicaid, 3232 Elder Street, Boise, Idaho, Conference Room D-West Moderator: Mark Turner, M.D. Committee Member Present:
More informationIdaho DUR Board Meeting Minutes
Idaho DUR Board Meeting Minutes Date: October 16, 2014 Time: 9am-2pm Location: Idaho Medicaid, 3232 Elder Street, Boise, Idaho, Conference Room D-West Moderator: Mark Turner, M.D. Committee Member Present:
More informationIdaho DUR Board Meeting Minutes. Committee Member Present: Matthew Hyde, Pharm.D., Perry Brown M.D., Paul Cady, Pharm.D., Ryan Heyborne M.D.
Date: February 16, 2017 Time: 9am-12:15pm Idaho DUR Board Meeting Minutes Location: Idaho Medicaid, 3232 Elder Street, Boise, Idaho, Conference Room D-West Moderator: Perry Brown, M.D. Committee Member
More informationDrug Utilization Review Board
DUR Members present DUR members absent MDCH/MMA/MPA present Steven Bernstein, M.D., Chair Carrie Germain, R. Ph, Vice Chair Bob DeYoung, PharmD James Forshee, M.D. Debera Eggleston, M.D. Sahar Swiden,
More informationCurbing Prescription Drug Abuse in Medicaid
Curbing Prescription Drug Abuse in Medicaid Joint Legislative Health Care Oversight Committee October 12, 2010 Dr. Lisa Weeks, BSPharm, PharmD Pharmacy and Ancillary Services Division of Medical Assistance
More informationFollow-up to Previous Reviews
21 January 2016 1 Follow-up to Previous Reviews Patients Receiving > 1 Long-Acting Opioid Multiple Dosage Forms of Aripiprazole Prescribed Concomitantly Multiple Dosage Forms of Oral Paliperidone Prescribed
More informationMonitoring Psychotropic Use Among Foster Children EMPAA
State Plans for Monitoring Psychotropic Use Among Foster Children EMPAA October 30, 2012 Child and Family Services Improvement and Innovation Act of 2011 Required Components of Psychotropic Oversight and
More informationIowa Medicaid Drug Utilization Review Commission Meeting Minutes March 3, 2010
Iowa Medicaid Drug Utilization Review Commission Meeting Minutes March 3, 2010 Attendees: Commission Members Bruce Alexander, R.Ph., Pharm.D., BCPP; Craig Logemann, R.Ph., Pharm.D., BCPS; Sara Schutte-Schenck,
More informationIdaho DUR Board Meeting Minutes. Committee Member Present: David Agler, M.D., Dawn Berheim, Pharm.D., Perry Brown, M.D., Matthew Hyde, Pharm.D.
Idaho DUR Board Meeting Minutes Date: January 25, 2018 Time: 9am-12:00pm Location: Idaho Medicaid, 3232 Elder Street, Boise, Idaho, Conference Room D-West Moderator: David Agler, M.D. Committee Member
More informationATTENDANCE PRESENT ABSENT EXCUSED
TO: Maine Drug Utilization Review Board DATE: March 14, 2014 RE: Maine DUR Board Meeting minutes from March 11, 2014 ATTENDANCE PRESENT ABSENT ECUSED Robert Weiss, M.D., Cardiologist, Chair Amy Enos, Pharm.
More informationIdaho DUR Board Meeting Minutes
Idaho DUR Board Meeting Minutes Date: April 14, 2016 Time: 9am-12:30pm Location: Idaho Medicaid, 3232 Elder Street, Boise, Idaho, Conference Room D-West Moderator: Mark Turner, M.D. Committee Member Present:
More informationPatient Review and Coordination Program
Patient Review and Coordination Program For Medical Assistance Clients Who Need Assistance In Appropriate Use of Phyllis Coolen, RN, MN Division of Healthcare Health and Recovery Administration January
More informationConnecticut Medical Assistance Pharmacy Program Drug Utilization Review (DUR) Program DUR Board Meeting
ATTENDEES Board Members Present: Kenneth Fisher, R.Ph. (Chair), Keith Lyke R.Ph., Dennis Chapron, M.S., Richard Gannon, Pharm.D., Bhupesh Mangla, M.D., Ram Illindala, M.D., Charles Caley, Pharm. D., Angela
More informationATTENDANCE PRESENT ABSENT EXCUSED Robert Weiss, M.D., Cardiologist, Chair X Amy Enos, Pharm. D. Waltz LTC Pharmacy
TO: Maine Drug Utilization Review Board DATE: April 10, 2014 RE: Maine DUR Board Meeting minutes from April 8, 2014 ATTENDANCE PRESENT ABSENT ECUSED Robert Weiss, M.D., Cardiologist, Chair Amy Enos, Pharm.
More informationSTOPP and START criteria October 2011
# START and STOPP are newer criteria to identify potentially inappropriate medications in elderly, including drug drug and drug disease interactions, drugs which increase risk of falls and drugs which
More informationMail Service Pharmacy
Mail Service s At A Glance Disclaimer: reserves the right to update its measures and measure sets to maintain measure relevancy and to remedy any unintended consequences that may arise during implementation.
More informationNews & Views. Antipsychotics on Maryland Medicaid PDL and Coverage of a 30-day Emergency Supply of Atypical Antipsychotics
Maryland Medicaid Pharmacy Program News & Views February 2011 Maryland Department of Health and Mental Hygiene /Office of Systems, Operations and Pharmacy Antipsychotics on Maryland Medicaid PDL and Coverage
More informationFollow-up to Previous Reviews. Multiple Dosage Forms of Aripiprazole Prescribed Concomitantly
15 October 2015 1 Follow-up to Previous Reviews Multiple Dosage Forms of Aripiprazole Prescribed Concomitantly 2 Multiple Dosage Forms of Aripiprazole Prescribed Concomitantly Usual maximum FDA approved
More informationDrug Utilization Review Board Minutes Draft
Drug Utilization Review Board Minutes Draft Name of Meeting: Drug Utilization Review Board Date of Meeting: August 10, 2017 Length of Meeting: 2 hours Location of Meeting: DMAS Board Room 13 th Floor Members
More informationEvaluation of a Medicaid Psychotropic Drug Management Program in Utah
Evaluation of a Medicaid Psychotropic Drug Management Program in Utah Dominick Esposito James M. Verdier 2008 SAMHSA/CMS Invitational Conference on Medicaid and Mental Health Service/Substance Abuse Treatment
More informationTennCare Drug Utilization Review (DUR) Board Minutes
State of Tennessee Department of Finance and Administration Bureau of TennCare 310 Great Circle Road Nashville, TN 37228 TennCare Drug Utilization Review (DUR) Board Minutes September 11, 2012 In attendance:
More informationUtibron Neohaler. (indacaterol, glycopyrrolate) New Product Slideshow
Utibron Neohaler (indacaterol, glycopyrrolate) New Product Slideshow Introduction Brand name: Utibron Neohaler Generic name: Indacaterol, glycopyrrolate Pharmacological class: Long-acting beta2- agonist
More informationIOWA MEDICAID DRUG UTILIZATION REVIEW COMMISSION 100 Army Post Road Des Moines, IA (515) Fax
IOWA MEDICAID DRUG UTILIZATION REVIEW COMMISSION 100 Army Post Road Des Moines, IA 50315 (515) 974-3131 Fax 1-866-626-0216 Brett Faine, Pharm.D. Larry Ambroson, R.Ph. Brian Couse, M.D. Professional Staff:
More informationPolicy and Issuance Patient Age Group: ( ) N/A ( ) All Ages ( ) Newborns ( X) Pediatric ( X) Adult
Applies To: Ambulatory Services Responsible Department: Ambulatory Admin Revised: 02/2018 Title: Controlled Substance Prescription Processing, Security Policy and Issuance Patient Age Group: ( ) N/A (
More informationUpdated: 08/2017 DMMA Approved: 11/2017
Request for Prior Authorization for Therapy to Treat Binge Eating Disorder Website Form www.highmarkhealthoptions.com Submit request via: Fax - 1-855-476-4158 All requests for medications to treat Binge
More informationGeneral Providers. Tamper-Resistant Prescription Requirements
September 2008 Provider Bulletin Number 8138 General Providers Tamper-Resistant Prescription Requirements Effective with processing dates on and after October 1, 2008, written prescriptions for Kansas
More informationCost-Effective Process to Improve Drug Adherence for Medicare 5-Star
Cost-Effective Process to Improve Drug Adherence for Medicare 5-Star HEALTH ALLIANCE PLAN Presented by Vanita K. Pindolia, Pharm.D. VP, Ambulatory Clinical Pharmacy Programs_PCM Medicare 5-Star Rating
More informationHot Topics: Transitions of Care
Our quarterly newsletter is a great way to stay up-to-date on emerging clinical information, medication safety issues, and Larkin s Hospital medication policies and procedures. Hot Topics: Transitions
More informationManaged Care Pushes for Safer Opioid Oversight
Page 1 of 6 Clinical AUGUST 11, 2017 Managed Care Pushes for Safer Opioid Oversight High-risk pain Rx eyed Denver Health systems haven t escaped the nation s ongoing opioid crisis, as evidenced by surging
More informationNote: Mandatory measures are those measures that are a requirement of accreditation and must be reported to URAC on an annual basis.
Note: Mandatory measures are those measures that are a requirement of accreditation and must be reported to URAC on an annual basis. DESCRIPTION NUMERATOR DENOMINATOR DM2012-12 Portion of Days Covered
More informationDrug Utilization Review & Cost Reduction Strategies. Esther Liu, PharmD, MSIA, CGP Clinical Pharmacist Outcome Resources
Drug Utilization Review & Cost Reduction Strategies Esther Liu, PharmD, MSIA, CGP Clinical Pharmacist Outcome Resources Goals and Objectives Define Drug Utilization Reviews Interpret various performance
More informationFL Medicaid Drug Therapy Management Program for Behavioral Health Monitoring for Safety and Quality
FL Medicaid Drug Therapy Management Program for Behavioral Health Monitoring for Safety and Quality April 23, 2014 Pensacola, FL Presentation Objectives To briefly describe the program and how its components
More informationNBPDP Drug Utilization Review Process Update
Bulletin # 802 December 1, 2010 NBPDP Drug Utilization Review Process Update The New Brunswick Prescription Drug Program (NBPDP) employs a Drug Utilization Review (DUR) process which identifies, investigates
More informationNote: Mandatory measures are those measures that are a requirement of accreditation and must be reported to URAC on an annual basis.
COMMUNITY PHARMACY V1.1 MANDATORY S Note: Mandatory measures are those measures that are a requirement of accreditation and must be reported to URAC on an annual basis. # NAME DESCRIPTION NUMERATOR DENOMINATOR
More informationTennCare Joint Committee for the Review of Narcotic Management Meeting Minutes
State of Tennessee Department of Finance and Administration Bureau of TennCare 310 Great Circle Road Nashville, TN 37228 TennCare Joint Committee for the Review of Narcotic Management Meeting Minutes April
More informationAlabama Medicaid Pharmacy Override
Alabama Medicaid Pharmacy Override Therapeutic Duplication, Early Refill, Maximum Unit, Prescription Limit Switchover, Dispense as Written, Accumulation Edit, Maintenance Supply Opt Out, and Maximum Cost
More informationThe Opioid Epidemic and How It is Impacting the Workplace. July 24, 2018
The Opioid Epidemic and How It is Impacting the Workplace July 24, 2018 In 2016 CDC reports a 300% increase in opioid prescription sales since 1999 without an overall change in reported pain National Safety
More informationIowa Medicaid Drug Utilization Review Commission Meeting Minutes February 5, 2014
Iowa Medicaid Drug Utilization Review Commission Meeting Minutes February 5, 2014 Attendees: Commission Members Laurie Pestel, Pharm.D.; Mark Graber, M.D., FACEP (via phone); Jason Wilbur, M.D. (via phone);
More informationNew Medicare Part D Prescription Opioid Policies for 2019 Information for Prescribers
CENTERS FOR MEDICARE & MEDICAID SERVICES New Medicare Part D Prescription Opioid Policies for 2019 Information for Prescribers Background CMS understands the magnitude of the nation s opioid epidemic and
More informationApril 21, 2010 DURB Meeting Summary
Roll Call Present: Dr. Swee, Ms. Olson, Ms. Martinez- Rodriguez, Dr. Barberio, Dr. Gooen, Dr. Gochfeld, Dr. Lichtbroun Absent: Dr. Moore, Dr. Marcus, Mr. Schafer, Dr. Moynihan, Review of Minutes Pages
More informationComprehensive support for your patients on MYALEPT
Comprehensive support for your patients on MYALEPT Insurance and financial assistance options (see page 3) Fulfillment support (see page 6) Co-pay assistance a,b (see page 4) Your patient Injection training
More informationMedicare Part D Opioid Policies for 2019 Information for Patients
CENTERS FOR MEDICARE & MEDICAID SERVICES Medicare Part D Opioid Policies for 2019 Information for Patients Introduction Prescription opioid pain medications like oxycodone (OxyContin ), hydrocodone (Vicodin
More informationExecutive Summary. Classes Under Review: Analysis:
Outcome Report on MHQAC Edits Classes Under Review: Analysis: Atypical Antipsychotics, SSRIs, SNRIs, Antianxietals, Hypnotics, and Drugs to Treat ADD/ADHD Utilization and Cost Trends: Pre and Post Implementation
More informationBest Practices in Prescribing Benzodiazepines. Michael Carlisle, DO Medical Director University Hospitals Geauga Medical Center
Best Practices in Prescribing Benzodiazepines Michael Carlisle, DO Medical Director University Hospitals Geauga Medical Center Objectives To review current practice guidelines in benzodiazepine prescribing
More informationMedicaid Perspective
Prescription Opioid Fraud and Abuse: Medicaid Perspective Presenter: Gary P. Gilmore, B.S., R.Ph. Director, Analysis & Reporting Office of Clinical Affairs Deputy Director, Pharmacy Program Objectives:
More informationFollow-up to Previous Reviews. Foster Children Prescribers (Nurse Practitioner Practice Sites)
15 January 2015 1 Follow-up to Previous Reviews Foster Children Prescribers (Nurse Practitioner Practice Sites) 2 Foster Children Prescribers (Nurse Practitioner Practice Sites) 3 Ongoing Reviews Buprenorphine
More informationCurbing the High Rates of Psychotropic Medication Prescriptions among Children and Youth in Foster Care
Curbing the High Rates of Psychotropic Medication Prescriptions among Children and Youth in Foster Care Appendices Appendix A Psych Meds Data Indicators by State The data elements being collected by the
More informationDrug Use Evaluation: Low Dose Quetiapine
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119
More informationMedicare Part D Prescription Opioid Policies for 2019 Information for Pharmacists
CENTERS FOR MEDICARE & MEDICAID SERVICES Medicare Part D Prescription Opioid Policies for 2019 Information for Pharmacists Background Opioid medications are effective at treating certain types of pain,
More informationTennCare Drug Utilization Advisory Board. October 1, 2013
TennCare Drug Utilization Advisory Board October 1, 2013 Agenda Call to Order Introductions Approval of Previous Minutes / Additions to the Agenda TennCare Update David Collier, MD Old Business ProDUR
More informationSTOPP START Toolkit Supporting Medication Review in the Older Person
STOPP START Toolkit Supporting Medication Review in the Older Person STOPP: Screening Tool of Older People s potentially inappropriate Prescriptions START: Screening Tool to Alert doctors to Right (appropriate,
More informationPolypharmacy. Polypharmacy. Suboptimal Prescribing in Older Adults. Kenneth Schmader, MD Professor of Medicine-Geriatrics
Polypharmacy Kenneth Schmader, MD Professor of Medicine-Geriatrics Polypharmacy Definition Causes Consequences Prevention/management Suboptimal Prescribing in Older Adults Overuse Polypharmacy Underuse
More informationBEERs For the Elderly
BEERs For the Elderly February 2008 Presented by:carla Ambrosini Seniors First Clinic Pharmacist 12/05/2008 1 Objectives To highlight the overall health care impact of drug related adverse reactions and
More informationThe Louis de la Parte Florida Mental Health Institute
Data Brief December 2003 Mary Rose Murrin, M.A. Kelley Dhont, M.S. David Thornton, M.A. The Louis de la Parte Florida Mental Health Institute Children s Psychotropic Medication Use by Age and Diagnostic
More informationIowa Medicaid Drug Utilization Review Commission Meeting Minutes October 5, 2011
Iowa Medicaid Drug Utilization Review Commission Meeting Minutes October 5, 2011 Attendees: Commission Members Mark Graber, M.D., FACEP; Casey Clor, M.D. ; Craig Logemann, R.Ph., Pharm.D., BCPS; Sara Schutte-Schenck,
More informationPharmacist s Role In Pain Management. Katrina Lynn, Pharm D PSHP Annual Assembly: October 12, 2017
Pharmacist s Role In Pain Management Katrina Lynn, Pharm D PSHP Annual Assembly: October 12, 2017 1 Presentation Objectives Briefly discuss Geisinger Health System and the use of Pain Management Pharmacists
More informationPolicy Evaluation: Substance Use Disorders
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119
More informationCynthia B. Jones, Director Department of Medical Assistance Services (DMAS)
Department of Medical Assistance Services 600 East Broad Street, Suite 1300 Richmond, Virginia 23219 MEDICAID MEMO http://www.dmas.state.va.us TO: All Prescribing Providers, Pharmacists, and Managed Care
More informationMaryland Department of Health and Mental Hygiene /Office of Systems, Operations and Pharmacy. Date Prescription will Start Denying at the
Maryland Medicaid Pharmacy Program & News ViewsNovember 2013 Maryland Department of Health and Mental Hygiene /Office of Systems, Operations and Pharmacy The Antipsychotic Peer Review Program is Expanding!
More informationPromoting and Monitoring Evidenced-Based Antipsychotic Prescribing Practices in Children and Adolescents: Florida Medicaid Initiatives
Promoting and Monitoring Evidenced-Based Antipsychotic Prescribing Practices in Children and Adolescents: Florida Medicaid Initiatives Mary Elizabeth Jones, Pharm BSc, RPh Senior Pharmacist AHCA Pharmacy
More informationAppropriate Use & Safety Edits
Appropriate Use & Safety Edits Envolve Pharmacy Solutions provides a variety of safety edits to promote the use of the right medication, in the right patient, at the right time. These edits are routinely
More informationManaging Opioid Overutilization Challenges
One Source. Lower Cost. Better Care. Managing Opioid Overutilization Challenges A LOOK AT REDUCING OPIOID OVERUTILIZATION BY 36 PERCENT Copyright 2017 MedImpact Healthcare Systems, Inc. All rights reserved.
More informationStark County Safety Council Presentation: Opioid & Anti-Anxiety Medication Use Among Ohio s Injured Workers
Stark County Safety Council Presentation: Opioid & Anti-Anxiety Medication Use Among Ohio s Injured Workers June 11, 2015 John Hanna, R.Ph. BWC, Pharmacy Director 6/24/2015 BWC Pharmacy Program Overview
More informationWA PMP Access by Public Payers. PDMP North Regional Meeting St. Louis, MO April 23-24
WA PMP Access by Public Payers PDMP North Regional Meeting St. Louis, MO April 23-24 Public Insurer Access PDMP Statute: Allows PDMP data to be provided to Medicaid and Workers Compensation Primary Goal:
More informationIntroducing ValueOptions Clinical Care Alerts
Introducing ValueOptions Clinical Care Alerts January 2013 Agenda What are Clinical Care Alerts? How does it work? What are the benefits? Questions and Answers 2 The Issue of Poor Medication Adherence
More informationMEDICATION GUIDE ANORO ELLIPTA
MEDICATION GUIDE ANORO ELLIPTA [a-nor oh e-lip-ta] (umeclidinium and vilanterol inhalation powder) for oral inhalation What is the most important information I should know about ANORO ELLIPTA? ANORO ELLIPTA
More informationDrug Utilization Review Board Minutes Draft
Drug Utilization Review Board Minutes Draft Name of Meeting: Drug Utilization Review Board Date of Meeting: March 22, 2018 Length of Meeting: 2 hours and 12 minutes Location of Meeting: DMAS Board Room
More informationJune 25, 2014 DURB Meeting Summary
Roll Call Present: Dr. Swee, Dr. Zanna, Dr. Gochfeld, Ms. Olson, Dr. Moore, Mr. Schafer, Dr. Gooen, Dr. Marcus, Dr. Lind (ex officio). Unable to attend: Dr. Moynihan, Dr. Barberio. Review of Minutes Pages
More informationTips for Evolving Medicaid Pharmacy Benefits Management (PBM) Programs. June 5, 2015
Tips for Evolving Medicaid Pharmacy Benefits Management (PBM) Programs 1 June 5, 2015 Introductions Mark Steck Pharm.D Independent Consultant, MAXIMUS John J.P. Crouse Vice President, MAXIMUS Market Lead
More informationMEDICAL ASSISTANCE BULLETIN
ISSUE DATE September 4, 2015 SUBJECT EFFECTIVE DATE September 9, 2015 MEDICAL ASSISTANCE BULLETIN NUMBER *See below BY Prior Authorization of Analgesics, Narcotic Long Acting and Analgesics, Narcotic Short
More informationHypertension. Risk of cardiovascular disease beginning at 115/75 mmhg doubles with every 20/10mm Hg increase. (Grade B)
Practice Guidelines and Principles: Guidelines and principles are intended to be flexible. They serve as reference points or recommendations, not rigid criteria. Guidelines and principles should be followed
More information2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process
Quality ID #325: Adult Major Depressive Disorder (MDD): Coordination of Care of Patients with Specific Comorbid Conditions National Quality Strategy Domain: Communication and Care Coordination 2018 OPTIONS
More informationFlorida MEDS-AD Waiver
Florida MEDS-AD Waiver 2 nd Quarter Report April 1, 2015 June 30, 2015 Demonstration Year 10 1115 Research and Demonstration Waiver #11-W-00205/4 This page intentionally left blank Table of Contents I.
More informationPhysician Injectable Drug List (PIDL) Department for Medicaid Services, HP, and Magellan Rx Management June 1, 2010
Physician Injectable Drug List (PIDL) Department for Medicaid Services, HP, and Magellan Rx Management June 1, 2010 Physician-Administered Drugs Physician-administered drugs are drugs, other than vaccines,
More informationWelcome - we will begin the webinar shortly Please read the participation tips below:
Welcome - we will begin the webinar shortly Please read the participation tips below: All guest phones have been muted: Background noises, conversations, white noise etc., can be disruptive to a webinar.
More informationApplication for Endorsement of CQI (Clinical Audit) Activities for MOPS Credits Allocation
Application for Endorsement of CQI (Clinical Audit) Activities for MOPS Credits Allocation Below is the form you need to fill out. NAME Dianne Vicary Health Hawke s Bay DATE JUNE 2012 TITLE OF ACTIVITY
More informationStatus of the CKD and ESRD treatment: Growth, Care, Disparities
Status of the CKD and ESRD treatment: Growth, Care, Disparities United States Renal Data System Coordinating Center An J. Collins, MD FACP Director USRDS Coordinating Center Robert Foley, MB Co-investigator
More informationChronic heart failure: management of chronic heart failure in adults in primary and secondary care (partial update)
Chronic heart failure: management of chronic heart failure in adults in primary and secondary care (partial update) NICE guideline Apendix C The algorithms Draft for consultation, January 2010 Chronic
More informationClinical risk management in community pharmacy - Henk Buurma SUMMARY
SUMMARY Summary This thesis starts with an introduction (Chapter 1) in which an overview of the recent history of community pharmacy practice is presented, and in which we elaborate on the evolving role
More informationFederal Fiscal Year 2015
20 October 2016 1 Federal Fiscal Year 2015 2 Background Section 1927(g)(3)(D) of the Social Security Act (the Act) requires each State to submit an annual report on the operation of its Medicaid Drug Utilization
More informationNM DRUG OVERDOSE PREVENTION QUARTERLY MEASURES REPORT THIRD QUARTER OF 2018 (2018Q3)
NM DRUG OVERDOSE PREVENTION QUARTERLY MEASURES REPORT THIRD QUARTER OF 218 () Substance Abuse Epidemiology Section Prescription Drug Overdose Prevention Program Injury and Behavioral Epidemiology Bureau
More informationCOPD Respiratory Antimuscarinics Drug Class Monograph
Line of Business: Medi-Cal Effective Date: May 17, 2017 Revision Date: May 17, 2017 COPD Respiratory Antimuscarinics Drug Class Monograph This policy has been developed through review of medical literature,
More informationIowa Medicaid Drug Utilization Review Commission Meeting Minutes May 5, 2010
Iowa Medicaid Drug Utilization Review Commission Meeting Minutes May 5, 2010 Attendees: Commission Members Craig Logemann, R.Ph., Pharm.D., BCPS; Sara Schutte-Schenck, D.O., FAAP; Laurie Pestel, Pharm.D.;
More informationOregon s PDMP: An epidemiological assist tool
Oregon s PDMP: An epidemiological assist tool Todd Beran Center for Prevention and Health Promotion Oregon Health Authority PDMP TTAC Webinar February 13, 2013 1 Acknowledgements Lisa Millet, MSH, Section
More informationNarcotics Monitoring System (NMS) Update
Narcotics Monitoring System (NMS) Update DISCLOSURE OF COMMERCIAL SUPPORT This program has received no financial or in-kind support. Potential for conflict(s) of interest: None Faculty/Presenter Disclosure
More informationThe University of Mississippi School of Pharmacy
LONG TERM PERSISTENCE WITH ACEI/ARB THERAPY AFTER ACUTE MYOCARDIAL INFARCTION: AN ANALYSIS OF THE 2006-2007 MEDICARE 5% NATIONAL SAMPLE DATA Lokhandwala T. MS, Yang Y. PhD, Thumula V. MS, Bentley J.P.
More information