CONNECTICUT MEDICAL ASSISTANCE DUR BOARD MEETING MINUTES SUMMARY CMS FFY 2003
|
|
- Morgan Morgan
- 5 years ago
- Views:
Transcription
1 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., Lori Jane Duntz Lord, R.Ph, Keith Lyke, R.Ph., Kathryn Mashey, DPM, Arturo Morales, M.D., Mike Moore, R.Ph., Frederick Rowland, M.D. SUMMARY OF DUR MEETING MINUTES December 12, 2002 Meeting Minutes Summary The meeting opened by welcoming the two new DUR Board members: Richard Gannon and Dennis Chapron. A review of the By-Laws and a reminder to the DUR Board members to submit their signed disclosure statements before the end of the meeting was addressed. Progress report was given on the development of a new DUR Website. The idea of re-instituting subcommittees to perform workgroup-type functions was discussed but received little Board support. Two Board members agreed to review the draft website and make suggestions instead of creating a subcommittee. June 2002 minutes still packed in a box and unavailable for final approval. Sept 2002 minutes approved as is. Monthly RetroDUR activity reports of patient profiles were reviewed. Michelle Laster-Bradley, ACS explained the Lock-In RetroDUR review program including selection of recipient for profile reviewing and possible lock-in to one pharmacy. Recipients with confirmed overuse by a Medical Review Committee are warned, then locked-in. RetroDUR program goals and provider educational materials were discussed. March 14, 2003 Meeting Minutes Summary The State of Connecticut Medical Assistance program website was announced as now being operational: ACS State Healthcare will post to and support the website at the direction of the State of Connecticut. The website contains all pharmacy program-related information, a Retrospective DUR section, a separate Prior Authorization section, and disclaimers. The State of CT Department of Social Services emphasized that all DUR functions are federallymandated and will be kept completely separate from the current state-mandated Prior Authorization program or any other new state-mandated initiative. DUR Board members were told that their names, professional degrees, and meeting minutes will be posted to the website. June 2002 DUR Board meeting minutes should be located for the June 2003 meeting. December 2002 minutes were NOT approved. The Board voted to postpone voting on acceptance of December 2002 meeting minutes because DUR Board members wanted more time to review. The DUR Board made the following requests: That they receive meeting packets 2 weeks in advance so that the Board has time to review, study, research and reasonably react to criteria, meeting minutes and other items presented.
2 continued Meeting Minutes Summary That ACS State Healthcare and DSS privacy attorneys discuss the information that is being sent out to providers to ensure that the letters being sent are in compliance with all relevant privacy and OBRA 90 DUR rules. Especially clarification, in writing, from the DSS and/or ACS privacy attorneys about whether state privacy laws allow disclosure of HIV, drug addiction, and psychotherapy treatment information on recipient profiles mailed with DUR intervention letters to prescribers. The following categories for criteria reviewed were: Overutilization, Drug-Drug Interactions included in Tramadol s black box warning on increased seizure risk with certain drugs; Cost Effectiveness, Overutilization - Inappropriate Duration, Duplication, and. (See Appendix A for specific criteria). One provider profiling criterion was reviewed and approved: Extended Use of PPI s Post-Hospitalization All newsletters will be posted to the website as developed. A Quarterly Newsletter was reviewed and approved with modifications. Newsletter topic: acetaminophen (APAP) Overuse defined as chronic daily doses greater than 4 grams more than 30 days. Target Audience: Prescribers & Pharmacies involved in recipients who hit the criteria for acetaminophen overuse. The Board was given one month to review and send any additional comments for this newsletter by or fax to Dr. Laster-Bradley. 4 th Quarter 2002 statistical activity summary report was presented. The report contained: Distribution of Cases, Intervention Topics for Regular RDUR & a Prescriber Response Summary. An average of 1,000 patient profiles are reviewed under the regular DUR program and about 500 patient profiles are reviewed under the Lock-In DUR program every month as part of the RetroDUR contract. Top Classes Report was presented Lock-In Selection Report was reviewed and how patients are selected for review for possible Lock-In to a single pharmacy was explained. June, 2003 Meeting Minutes Summary The June 2002 approved minutes were located and were re-approved as is by the DUR Board. September 2002 meeting minutes were approved as is. December 2002 minutes will be presented at the December 2003 Meeting. March 2003 meeting minutes were approved as amended. Jim Zakszewski, pharmacist for CT Dept of Social Services reminded DUR Board members and attendees that the new CT pharmacy program website was available: Four On-site statewide provider educational training programs occurred between May 2 and June 4 with 3 hours of live-continuing Education available. There were three 50-minute sections: Retrospective DUR, Medical Audits, and Prior Authorization Training packets were given to each DUR Board member in their meeting packets. Highlights reported included: - Training packets available from ACS State Healthcare if providers couldn t attend - The Medical Auditor told providers at training that: Medicaid law will not permit cash payments by clients. The DUR Board suggested that ACS post this statement on the website. - The Lock-In program was explained to many providers for the first time. Recipients are given warnings before being locked-in to a pharmacy of their choice.
3 Attachment 4 continued Meeting Minutes Summary Other DUR Educational Intervention Materials Report Three mailings were conducted where retrospective analyses were used. The letter content was presented to the Board as an FYI only. However, it was emphasized that the RetroDUR Board had nothing to do with PA mailings or with the PA program and that only RetroDUR decisions were made in these Board meetings. The mailings were in preparation for the CT Medical Assistance Pharmacy Prior Authorization Program implementation date of July 16, The mailings were as follows: Announcement Letter about Pharmacy Prior Authorization implementation. Prescribers, pharmacies and recipients who had received greater than 2 prescriptions in the most previous 90 days were mailed a letter describing the Pharmacy Prior Authorization Program. Two Targeted Letter mailings about CT Medical Assistance Pharmacy Prior Authorization Program implementation. Prescribers and pharmacists who had dispensed, and recipients who had taken Brand medications with at least 2 A -rated generics available or who had obtained early refills were identified and mailed letters. RetroDUR Activity Report Statistical Activity Summary Report RetroDUR intervention activity by month for the past several months was reported. Dr. Laster-Bradley explained that ACS, as the contractor, normally reviewed an average of about 1,000 patient profiles under the regular RetroDUR program and about patient profiles under the Lock-In DUR program. Due to the DSS attorney s concern about disclosure of prescription and diagnoses information to patient s prescribers, only one RetroDUR intervention had occurred since HIPAA privacy rules went into effect April 15, The Board was advised that the DSS attorney was aware that RetroDUR interventions (where letters and patient profiles are sent to prescribers identifying potential problems) have been required and conducted for 13 years by OBRA 90. However, the attorney wanted to send limited, partial drug information and no diagnoses. The Board felt very strongly that all prescription and medical history available was necessary and devised a Position Statement to give to DSS. (See Position Statement). The Board also requested that the position statement be included in the CMS Annual Report. The Board specifically asked that the Position Statement be included in Attachment 6 in the section describing Connecticut s RetroDUR program to warn CMS that restricted information may be provided in the near future as a result of HIPAA and how opposed they were to restricted information. CMS Federal Fiscal Year 2002 Annual Report The RetroDUR portion of the annual CMS report for 2002 was presented along with cost savings by month (or each RetroDUR intervention). Savings on each topic of intervention were as follows: Intervention Month Regular RetroDUR Program Topic Savings/ Recip Intervened Jun 02 Inappropriate Use of Long-Acting Benzodiazepines in Elderly (Clonazepam) $ Jul 02 Inapprop. Use of long-acting Benzos in Elderly (CDP, diazepam, flurazepam) -$1.11 Jul 02 Overuse: Chronic xs use of APAP-containing pain relievers (> 4 grams per day) $ Aug 02 Overuse: Long term use of antibiotics with no supporting diagnosis $ Sep 02 Overuse: Chronic overuse of Butalbital-containing products (daily > 3mo) $ Sep 02 Duplication of Cox-2 Inhibitors $ Sep 02 Chronic Use of carisoprodol & history of alcohol or drug abuse $ Total Savings in 4 months of Regular RetroDUR: $265,920.30
4 Attachment 4 continued Meeting Minutes Summary September, 2003 Meeting Minutes Summary December 2002 meeting minutes were approved as amended. June 2003 meeting minutes were approved as amended. An update on the HIPAA privacy issues was given by Terry Wheeler, B.S., J.D., ACS State Healthcare. The Board was informed of a conference call that took place in July with ACS and the DSS attorney Phyllis Hyman. Both sides decided to continue working the programs with the distribution of information as it had been prior to HIPAA. Terry Wheeler gave a brief overview of the Prior Authorization (PA) program discussing which situations would warrant a PA as well as what forms or documents are necessary to obtain a PA. A question and answer session followed suit. A listing of previously approved criteria was presented. Ms. Wheeler pointed out that there were still interventions left from that list that could last the retrodur department through the end of the year. Three other possible interventions (new criteria) were then presented and discussed by the Board. The following were approved: o Heart Failure Therapy and the use of beta-blockers as October s intervention cycle. o Use of ACEIs in diabetic patients to prevent kidney damage as November s intervention cycle. o Underutilization of beta-blockers in post MI patients as December s invention cycle. Use of the drug Tarka [verapamil/trandolapril] was introduced for its possible role in the November intervention. Since the clinical evidence does not currently support this indication, it was not included however Board members will be provided with a report as it relates to diabetics in the future. Second quarter Activity Reports and Quarterly Utilization by Program Reports were reviewed Questions from the Board regarding the Lock-In program and guidelines for which physicians could recommend patients to the program were considered resulting in a request for a newsletter containing this information on the website. The Board requested data for drugs with narrow therapeutic indexes such as warfarin and digoxin as well as information on hospitalizations that could have been caused by certain drug combinations resulting in arrhythmias, hyperkalemia, and hypoglycemia such as glyburide/bactrim, digoxin/biaxin, and ACEIs containing potassium-sparing diuretics. Other future intervention possibilities include: o If sudden death occurred in diabetics who were using atypicals o o o Use of warfarin in patients with a diagnosis of atrial fibrillation Potential precipitator effects of nonsteroidal prescriptions patients with CHF or Renal Insufficiency If patients on Prilosec [prior to its OTC status change] were switched to another PPI that is covered by Medicaid Lastly, Evelyn Dudley from DSS verified that the bylaws pulled from ACS P drive with an original date of January 1993 and a revision date of March 2002 is the most current and correct version. A copy of this version was given to all Board members present.
5 Attachment 4.B Connecticut Retro Additions, Deletions, & Changes FFY2003 September 2002 CMS Category Board Long-Term Use of Antibiotics without diagnosis to support Overutilization Approved Sumatriptan use with diagnosis of hypertension Inappropriate use Tabled Long term use of Proton Pump Inhibitors Overutilization Tabled Dose optimization of Statins, PPI, and COX II Cost Effectiveness Approved Incorrect billing quantities Pharmacy Profiling Approved December 2002 & March 2003 CMS Category Board Long term use of Proton Pump Inhibitors Overutilization Revised Tramadol Overutilization Overutilization Tramadol Use with History of Drug Abuse Overutilization Reject Tramadol/ SSRI Serotonin Syndrome Drug-Drug Interaction Reject Tramadol/CNS Depressants Drug-Drug Interaction Reject Tramadol / Warning of Increased Seizure Threshold Risk Drug-Disease (Black Box Warning) Reject Tramadol/Drugs with Increased Seizure Threshold (Board decided that this criterion was more useful than above) Drug-Drug Interaction Tramadol/Intracranial Disease and Drug Withdrawal Drug-Disease Interaction Reject Tramadol/Drugs which Inhibit CYP2D6 Drug-Drug Interaction Tabled Tramadol/Naloxone Drug-Drug Interaction Reject Tramadol/Digoxin Drug-Drug Interaction Reject Tramadol/Warfarin Drug-Drug Interaction Reject Risperidone/Antihypertensives Drug-Drug Interaction Reject RDUR too late by the time this happens Risperidone/Antihistamines Drug-Drug Interaction Reject Convert Flovent and Serevent to Advair Cost Effectiveness Aciphex/General Medicines/ Single Daily Dose Cost Effectiveness Reject March 2003 Board CMS Category Addition of Zetia to HMG therapy when patient is taking highest recommended dose and does not meet target LDL goal or exceeds recommended dose. Tabled - Table until have better clinical data Indiscriminant use of COX2s in young patients w/ no GI dx history Inappropriate Therapy/ OverUse Dose Optimization of Aricept Cost Effectiveness Clopidogrel / Atorvastatin Drug-Drug Interaction Reject Diabetes /ACE inhibitors Post MI Drugs/ MI (ICD-9 s)/ Beta Blockers Atrial Fib. Drugs &/or Atrial Fib. ICD-9 s / Coumadin Inappropriate Therapy Long Term Use of PPIs After Inpatient Discharge Overutilization Duplicate/Triplicate PPIs or Duplicate or Triplicate COX2 s Duplication
6 Attachment 4.B - continued - Connecticut Retrospective June 2003 CMS Category Board No Criteria Presented in June 2003 September 2003 Heart Failure Therapy (in general) and the Use of Beta- Blockers Adding ACE Inhibitors in Diabetics to preserve kidney function Adding Beta-Blocker Therapy in Post-MI patients CMS Category Board
7 CONNECTICUT MEDICAL ASSISTANCE RETROSPECTIVE DUR CRITERIA Attachment 4-B Criteria Bank - Approval Process CMS FFY 2003 INAPPROPRIATE DOSE THERAPEUTIC DUPLICATION DRUG ALLERGY INTERACTION 1. Lipid Lowering Agents/Dose Optimization* 1. (ACS)_Valdecoxib and other Cox II Inhibitors* 1. NONE 2. #566 Sonata & Ambien/Geriatric Dose 2. (ACS) Multiple Narcotics Agents* #571 Mid Range Analgesics/Overuse* 3. _(ACS#3) PPIs and PPIs/H2 Antagonists*_ #585 Diphenoxylate-Atropine/Overuse* #642 Butalbital/Overuse* #569 Buspirone/Overuse* #606 Migraine Specific Meds/Overuse* (ACS) Butalbital Use > QD Average* INAPPROPRIATE DURATION DRUG/DRUG INTERACTION DRUG DISEASE CONTRAINDICATION 1. #564 Sedatives/Duration* 1. #558 Thioridazine/ Certain Beta Blockers* 1. Thioridazine/QT Syndrome* 2. #638 Carisoprodol & Meprobamate/Duration* 2. #559 Thioridazine/SSRI s* 2. Sedative-Hypnotics/Depression* 3. (ACS) Chronic xs APAP Cont. Pain Relievers3. #565 Sonata/Potent Enzyme Inducers* 3. Protease Inhibitors/Diabetes* _ 4. (ACS) Long Term Use Of Antibiotics:NoDx* 4. #584 Triazolam/Rifampin* 4. Famotidine/Renal Insufficiency* 5. (ACS) Long Term Use Of Narcotics: No Dx* 5. HID Protease Inhibitors/Lovastat&Simvastatn* 5. HID Narcotics & Carisoprodol/Drug Abuse* 6. Chronic Overuse of APAP Cont. Pain Relievers 6. HID Controlled Subst/Drug Depdence(add LI crit.)* (ACS) Carisoprodol & Hx of Alcohol/Drug Abuse* (ACS) Narcotics & Hx Alcohol/Drug Abuse/Depnd* OTHER: COST APPROPRIATENESS OTHER: THERAPEUTIC APPROP. OTHER: GENERIC APPROPRIATENESS SPECIFY SPECIFY SPECIFY 1. NONE 1. #586 Clozapine & Olanzapine/Diabetes* 1. NONE #641 Benzo-Anxiolytics/Approp.Geriatric Meds* #590 Barbiturate Sedatives/AppropGeriatric Med* #591 Teritary TCA's/Appropriate Geriatric Meds* #592 Linezolid/Myleosuppression* #604 Famotidine/Appropriate Geriatric Meds* #604 Famotidine/Appropriate Geriatric Meds* 7. FOR EACH PROBLEM TYPE LIST (DRUGS / DRUG CATEGORY / DISEASE COMBINATIONS) FOR WHICH DUR BOARD CONDUCTED IN-DEPTH REVIEWS. PLEASE INDICATE WITH AN ASTERICK THOSE FOR WHICH CRITERIA WERE ADOPTED.
Connecticut 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
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
More informationConnecticut 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
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
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
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
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 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 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 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 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 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 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 informationPHARMACY Section 9. Overview. Preferred Drug List. Additions and Exceptions to the Preferred Drug List
Overview The management of outpatient prescription drugs is an integral part of the medical management program to improve the health and well-being of our members. Prescriber and member involvement is
More informationChanges to the Eighth Edition
Pharmacy Practice and the Law, Eighth Edition Includes Navigate 2 Advantage Access By Richard R. Abood, BS Pharm, JD-Professor Emeritus Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences,
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 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 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 informationCondition/Procedure Measure Compliance Criteria Reference Attribution Method
Premium Specialty: Cardiology Credentialed Specialties include: Cardiac Diagnostic, Cardiology, Cardiovascular Disease, Clinical Cardiac Electrophysiology, and Interventional Cardiology This document is
More informationTexas Vendor Drug Program Specialty Drug List Process. February 2019
Texas Vendor Drug Program Specialty Drug List Process February 2019 Table of Contents Table of Contents...1 1 About the Specialty Drug List...2 1.1 Information for Pharmacies... 2 1.2 Information for Managed
More informationNorth Dakota Board of Pharmacy
North Dakota Board of Pharmacy Updates on Drug Abuse Trends, the PDMP and Medical Marijuana Mark J. Hardy, Pharm D Executive Director Disclosure Statement I have no conflict of interests to report Objectives
More informationNEWSLETTER DUE CARE PROGRAM. WINTER 2014 Summer 2015 COMMONLY ASKED QUESTION:
DUE CARE PROGRAM NEWSLETTER WINTER 2014 Summer 2015 Lisa Sather, RPh DUR Coordinator Mountain-Pacific Quality Health 3404 Cooney Drive Helena, MT 59602 406-457-5818 The DUE CARE PROGRAM, administered by
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 informationJune 23, 2010 DURB Meeting Summary
Roll Call Present: Dr. Swee, Ms. Olson, Ms. Martinez- Rodriguez, Dr. Barberio, Dr. Gooen, Dr. Gochfeld, Dr. Lichtbroun, Dr. Marcus Absent: Dr. Moore, Mr. Schafer, Dr. Moynihan, Review of Minutes Pages
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
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 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 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 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 informationPBMs: Impact on Cost and Quality of Pharmaceutical Care in the U.S.
Speaker Brian K. Solow, MD, FAAFP Optum Life Sciences Irvine, CA, USA PBMs: Impact on Cost and Quality of Pharmaceutical Care in the U.S. Brian K. Solow, MD, FAAFP Chief Medical Officer, Optum Life Sciences
More informationAll Indiana Medicaid Prescribers and Pharmacy Providers
P R O V I D E R B U L L E T I N BT200148 NOVEMBER 28, 2001 To: All Indiana Medicaid Prescribers and Pharmacy Providers Subject: Note: The information in this bulletin regarding prior authorization payment
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 information4/24/15. New Mexico s Prescription Monitoring Program. Carl Flansbaum, RPh. PMP Director New Mexico Board of Pharmacy. New Mexico and the PMP
New Mexico s Carl Flansbaum, RPh. PMP Director New Mexico Board of Pharmacy New Mexico and the PMP In 2012, New Mexico had the 3 nd Highest Overdose Death Rate in Nation.! 492 Deaths or a rate of 23.6
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 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 informationClinical Policy: Opioid Analgesics Reference Number: CP.PMN.97 Effective Date: Last Review Date: 02.19
Clinical Policy: Reference Number: CP.PMN.97 Effective Date: 02.11 Last Review Date: 02.19 Line of Business: Medicaid Revision Log See Important Reminder at the end of this policy for important regulatory
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 informationCOMMON DRUG RELATED PROBLEMS SEEN IN PACE AND MECHANISMS TO MITIGATE RISK
COMMON DRUG RELATED PROBLEMS SEEN IN PACE AND MECHANISMS TO MITIGATE RISK Robert L Alesiani, PharmD, CGP Chief Pharmacotherapy Officer CareKinesis, Inc. (a Tabula Rasa Healthcare Company) 2 3 4 5 Pharmacogenomics
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 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 informationA COMPREHENSIVE APPROACH TO MANAGING DIABETES
A COMPREHENSIVE APPROACH TO MANAGING DIABETES Programs and services to help individuals avoid costly complications and improve outcomes 2 0 1 8 ENTER Supporting each member with targeted guidance and services.
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 informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: Reference Number: LA.PPA.12 Effective Date: 02/11 Last Review Date: 01/18 Line of Business: Medicaid Coding Implications Revision Log See Important Reminder at the end of this policy for
More informationClinical Policy: Opioid Analgesics Reference Number: CP.PMN.97 Effective Date: Last Review Date: 02.18
Clinical Policy: Reference Number: CP.PMN.97 Effective Date: 02.11 Last Review Date: 02.18 Line of Business: Medicaid Revision Log See Important Reminder at the end of this policy for important regulatory
More informationAmy Larrick Chavez-Valdez, Director, Medicare Drug Benefit and C & D Data Group
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, Maryland 21244-1850 CENTER FOR MEDICARE TO: FROM: SUBJECT: All Part D Sponsors Amy Larrick
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 informationPROCEDURE REF NO SABP/EXECUTIVE BOARD/0017
PROCEDURE REF NO SABP/EXECUTIVE BOARD/0017 NAME OF GUIDELINE REASON FOR GUIDELINE WHAT THE GUIDELINE WILL ACHIEVE? WHO NEEDS TO KNOW ABOUT IT? Medicines Guideline: Hypnotic Medication Compliance with NICE
More informationMedicare Part D Overutilization Monitoring System
Medicare Part D Overutilization Monitoring System Lisa Thorpe, Division of Part D Policy Gary Wirth, Division of Clinical and Operational Performance Medicare Drug Benefit and C&D Data Group July 17, 2013
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 informationDEPARTMENT OF HEALTH MEDICAID PAYMENTS FOR DIABETIC TESTING SUPPLIES. Report 2008-S-123 OFFICE OF THE NEW YORK STATE COMPTROLLER
Thomas P. DiNapoli COMPTROLLER OFFICE OF THE NEW YORK STATE COMPTROLLER DIVISION OF STATE GOVERNMENT ACCOUNTABILITY Audit Objective... 2 Audit Results - Summary... 2 DEPARTMENT OF HEALTH Background...
More informationFlorida MEDS-AD Waiver
Florida MEDS-AD Waiver Quarterly Progress Report January 1, 2014 March 31, 2014 1115 Research and Demonstration Waiver #11-W-00205/4 This page intentionally left blank Table of Contents This page intentionally
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 informationIOWA MEDICAID DRUG UTILIZATION REVIEW COMMISSION 100 Army Post Road (515)
IOWA MEDICAID DRUG UTILIZATION REVIEW COMMISSION 100 Army Post Road (515) 974-3131 -866-626-0216 Brett Faine, Pharm.D. Larry Ambroson, R.Ph. Brian Couse, M.D. Professional Staff: Mark Graber, M.D., FACEP,
More information2016 Dr. Douglas H. Kay CPE Symposium
GREGORY CAMERON, R.Ph ASSISTANT PROFESSOR OF PHARMACY PRACTICE FIELD COORDINATOR COMMUNITY SITES HUSSON UNIVERSITY SCHOOL OF PHARMACY November 5, 2016 Please Silence All Electronic Equipment OBJECTIVES
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 information2015 Healthy Heart. Program Evaluation. Our mission is to improve the health and quality of life of our members
2015 Healthy Heart Program Evaluation Our mission is to improve the health and quality of life of our members 2015 Healthy Heart Program Evaluation Program Title: Healthy Heart Program Evaluation Period:
More informationUSING MTM TO IMPROVE STAR RATINGS : CASE STUDIES
USING MTM TO IMPROVE STAR RATINGS : CASE STUDIES Sept 13, 2015 Amanda Applegate, PharmD, BCACP Disclosures Nothing to disclose Learning Objectives Describe how MTM can improve star ratings Discuss strategies
More informationVELTASSA (patiromer) oral suspension
VELTASSA (patiromer) oral suspension Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Pharmacy
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 informationNSAIDs Change Package 2017/2018
NSAIDs Change Package 2017/2018 Aim: To Reduce harm to patients from Non-Steroidal Anti-inflammatory Drugs (NSAIDs) in primary care Background A key aim of the Safety in Practice programme is to reduce
More informationBENAD A RY R L L ITCH STOPPING GEL
OTC Medications and How They Can Cause Harm Presenter: Joseph DuPrey MS RPh February 26, 2009 Why are some Medications OTC? FDA has established safety profile FDA established OTC drug review FDA regulated
More informationHIPAA FOR THE DENTAL PRACTICE
HIPAA FOR THE DENTAL PRACTICE Catherine C. Cownie Adam J. Freed E-mail: cownie@brownwinick.com E-mail: freed@brownwnick.com Telephone: 515-242-2490 Telephone: 515-242-2402 BrownWinick Law Firm 666 Grand
More informationNHS QIS National Measurement of Audit Acute Coronary Syndrome
NHS QIS National Measurement of Audit Acute Coronary Syndrome Things have changed based on the experience and feedback from the first cycle of measurement and, for the better we think! The Acute Coronary
More informationPharmacy Law Disclosure Statement. Objectives 6/11/2016. I have no conflicts of interest to disclose related to this presentation.
Pharmacy Law 2016 Ronda H. Lacey, J.D., M.S. Pharm Disclosure Statement I have no conflicts of interest to disclose related to this presentation. Objectives At the conclusion of this continuing education
More informationAbout the PCTB Examination Assisting the Pharmacist in Serving Patients p. 1 Filling the Medication Order p. 3 Receiving the Medication Order p.
Preface p. ix About the PCTB Examination p. xii Assisting the Pharmacist in Serving Patients p. 1 Filling the Medication Order p. 3 Receiving the Medication Order p. 4 The Retail Medication Order p. 6
More information19 TH JUDICIAL DUI COURT REFERRAL INFORMATION
19 TH JUDICIAL DUI COURT REFERRAL INFORMATION Please review the attached DUI Court contract and Release of Information. ******* You must sign and hand back to the court the Release of Information today.
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 informationMetformin MR to low cost branded generic (Sukkarto SR) Switch Protocol
Metformin MR to low cost branded generic (Sukkarto SR) Switch Protocol Applies to HaRD CCG employed Pharmacists and Medicines Optimisation Technicians. These protocols are produced by the NY&AWC MM team
More informationPRESCRIBING GUIDELINES
Ohio Department of Health RESPONSE TO OHIO S PRESCRIPTION DRUG OVERDOSE EPIDEMIC: PRESCRIBING GUIDELINES MIPA CONFERENCE PREVENTING INJURY: FROM RESEARCH TO PRACTICE TO PEOPLE SEPTEMBER 30, 2013 Christy
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 informationCOLLEGE OF PHYSICIANS AND SURGEONS OF NOVA SCOTIA DECISION OF INVESTIGATION COMMITTEE A. Mr. Kevin Lynch, Manager, PMP XXXXXXXXXXX
COLLEGE OF PHYSICIANS AND SURGEONS OF NOVA SCOTIA IN THE MATTER OF: DECISION OF INVESTIGATION COMMITTEE A COMPLAINANT: PHYSICIAN: Mr. Kevin Lynch, Manager, PMP XXXXXXXXXXX Dr. Philip Davis PROCESS: This
More informationQuestions and answers about HCA s opioid clinical policy for Apple Health (Medicaid)
Questions and answers about HCA s opioid clinical policy for Apple Health (Medicaid) This Q&A covers questions the Health Care Authority (HCA) received during webinars about the opioid clinical policy
More informationChitra Fernando, MD March 18, 2008
Chitra Fernando, MD March 18, 2008 Definition Statistics Risk factors Why older adults are more prone to ADE Manifestations Inappropriate medications for older adults What can be done to minimize adverse
More informationWisconsin Statewide Substance Abuse Prevention Training Wisconsin Dells June 12, 2015
Wisconsin Statewide Substance Abuse Prevention Training Wisconsin Dells June 12, 2015 1 Presenter Andrea Magermans Program Analyst of the Wisconsin PDMP Wisconsin Department of Safety and Professional
More informationClinical Policy: Opioid Analgesics Reference Number: OH.PHAR.PPA.13 Effective Date: 10/2017 Last Review Date: 6/2018 Line of Business: Medicaid
Clinical Policy: Reference Number: OH.PHAR.PPA.13 Effective Date: 10/2017 Last Review Date: 6/2018 Line of Business: Medicaid Revision Log See Important Reminder at the end of this policy for important
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. Casey Clor, M.D. Mark Graber, M.D.,
More informationIntelligent Polypharmacy. Professor Colin P Bradley Department of General Practice University College Cork
Intelligent Polypharmacy Professor Colin P Bradley Department of General Practice University College Cork Polypharmacy No standard definition 2005 review the use of medications that are not clinically
More informationControlled Substances: A survey of tools and resources required by hospital pharmacists
Controlled Substances: A survey of tools and resources required by hospital pharmacists TABLE OF CONTENTS 2018. Canadian Society of Hospital Pharmacists About the survey 1 The Short and Snappy 1 What CSHP
More informationPharmacy Coverage Guidelines are subject to change as new information becomes available.
Ezetimibe-simvastatin 10-80 mg oral tablet Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Pharmacy
More informationBree Collaborative AMDG Opioid Prescribing Guidelines Workgroup. Opioid Prescribing Metrics - DRAFT
Bree Collaborative AMDG Opioid Prescribing Guidelines Workgroup Opioid Prescribing Metrics - DRAFT Definitions: Days Supply: The total of all opioid prescriptions dispensed during the calendar quarter
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 informationPharmaceutical Management Medicaid 2019
Pharmaceutical Management Medicaid 2019 Toll-free Contact Number: (888) 327-0671 Pharmacy Administration: (810) 244-1660 Introduction Pharmaceutical Management promotes the use of the most clinically appropriate,
More informationCalifornia. Prescribing and Dispensing Profile. Research current through November 2015.
Prescribing and Dispensing Profile California Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points
More information9/9/2016. Drug Name (select from list of drugs shown) Bunavail Buccal Film (buprenorphinenaloxone) Suboxone Sublingual Film (buprenorphine-naloxone)
9/9/2016 Prior Authorization Form PASSPORT HEALTH PLAN KENTUCKY MEDICAID Buprenorphine Products This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information,
More informationDo Not Reproduce. Things to Tell Your Health Care Provider
Note: This CareKit does not replace expert medical care. 2 Things to Tell Your Health Care Provider Before medicine is prescribed, tell him or her: Medicines on your health plan s preferred drug list (formulary).
More informationGuidance on Bulk Prescribing for Care Home Patients
Guidance on Bulk Prescribing for Care Home Patients Introduction Many patients in care homes taking medicines when required (PRN) can inevitably present problems for the prescriber in determining the quantity
More informationUsing CURES to combat prescription drug abuse/misuse
Using CURES to combat prescription drug abuse/misuse Speakers Nathan Painter PharmD, CDE Email: npainter@ucsd.edu Rabia Atayee, PharmD, BCPS Email: ratayee@ucsd.edu UC San Diego Skaggs School of Pharmacy
More informationApril 26, New Mexico Board of Pharmacy Prescription Monitoring Program (PMP) New Mexico Board of Pharmacy Prescription Monitoring Program (PMP)
New Mexico Board of Pharmacy Prescription Monitoring Program (PMP) New Mexico Nurse Practitioner Council New Mexico Board of Pharmacy Prescription Monitoring Program (PMP) Peter Ryba, PharmD PMP Director
More informationANNUAL REPORT
ANNUAL REPORT - 2015 New Hampshire Prescription Drug Monitoring Program Report for July 1, 2014 June 30, 2015 Published October 2015 Table of Contents Executive Summary... 3-4 NH PDMP Background Information
More informationPharmacy Technician Course
Pharmacy Technician Course VERSION HISTORY SECTION 1: History and Scope of the Pharmacy Technician Scope of the Pharmacy Technician Section 1 Quiz Check Your Knowledge Section 1 Quiz Answers SECTION 2:
More informationMark W. Caverly, Chief Liaison and Policy Section
DEA Issues: An Update Harold Rogers National Prescription Drug Monitoring Meeting Meeting September 24 25, 2009 Mark W. Caverly, Chief Liaison and Policy Section Prescription Drug Abuse Prescription Drug
More informationADMINISTRATIVE POLICY AND PROCEDURES MedStar Family Choice Medicare Advantage Plans
ADMINISTRATIVE POLICY AND PROCEDURES MedStar Family Choice Medicare Advantage Plans DEPARTMENT: Medicare Compliance POLICY TITLE: RELATED DEPARTMENTS: All POLICY #: 706 C VERSION #: 4 REVISION DATE: Identifying
More informationAn Overview of One Formulary Making Decision Process
An Overview of One Formulary Making Decision Process Disclosure Statement & Speaker s Non- Commercialism Agreement Rodney J. Gedey Presenter has no conflict of interest to disclose. This presentation was
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 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 informationSTATE OF NEW JERSEY OFFICE OF THE STATE COMPTROLLER MEDICAID FRAUD DIVISION
STATE OF NEW JERSEY OFFICE OF THE STATE COMPTROLLER MEDICAID FRAUD DIVISION COMPLIANCE AUDIT REVIEW OF SUBOXONE FINAL AUDIT REPORT A. Matthew Boxer September 25, 2013 COMPTROLLER Executive Summary As part
More informationThe Oregon Opioid Initiative. State Pain & Opioid Conference Prescription Drug Monitoring May 2018 Lisa Millet, Public Health Division
The Oregon Opioid Initiative State Pain & Opioid Conference Prescription Drug Monitoring May 2018 Lisa Millet, Public Health Division Disclosure No disclosures 2 Learning Objectives Learner will be able
More informationReport to the Legislature: Unsolicited Reporting Criteria Established and Process Review MN Prescription Monitoring Program
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Minnesota Board of
More information