Medicaid Managed Care Open Enrollment Extended through Dec. 15
Current Suspected Overdose Deaths in Delaware for 2017: 227
The Omnibus Reconciliation Act of 1990 mandated that each State establish a drug use review (DUR) program by January 1, 1993. The purpose of the DUR program is to improve the quality of pharmaceutical care by ensuring that prescriptions are appropriate, medically necessary, and that they are not likely to cause adverse medical results.
The Drug Utilization Review Board was established by the Delaware Department of Health and Social Services (DHSS) to evaluate standards of drug use in Delaware’s Medical Assistance Programs . The Board is responsible for conducting both retrospective and prospective drug use reviews (DURs). The DUR Board also recommends and evaluates educational intervention programs. The Code of Federal Regulations lists the requirements for the DUR program in Title 42, Part 456, subpart K.
The Board consists of eleven members: four members are pharmacists who are licensed and actively practicing in Delaware, three members are physicians who are licensed and actively practicing in Delaware, three members are public citizens who have relevant health care experience, and two members have crossover appointments on the Pharmaceutical and Therapeutics Committee. The pharmacists are nominated by the Delaware Pharmacists Society, the physicians are nominated by the Medical Society of Delaware, and the public members are nominated by the Department of Health and Social Services. Each Board member is appointed for a three (3) year term and may be reappointed. The Secretary of the Department of Health and Social Services appoints all DUR Board members. The Board elects a Chairperson and Alternate Chairperson from among its members. The chairperson presides at all meetings of the DUR Board, which are held at least quarterly.
The DUR Board reviews predetermined standards of drug use submitted to it by the Medicaid agency or the agency's contractors. The Board evaluates the use of these standards and recommends modifications, including the elimination of existing predetermined standards or the addition of new ones. The Board makes recommendations for which combination of interventions would most effectively lead to improvement in the quality of drug therapy, and periodically re-evaluates and, if necessary, modifies the recommended interventions. The Department of Health and Social Services retains the authority to accept or reject the recommendations of the DUR Board.
All DUR Board meetings are open to the public. The DUR Board may make and enforce reasonable rules regarding the conduct of persons attending its meetings. Opportunities are provided for individuals, or citizens representing a group or groups, to appear on the agenda. Requests to appear before the DUR Board must be made in writing and received ten days before a scheduled meeting, including subject matter and speaker name for inclusion on the agenda. The ten day requirement may be waived by the Chairperson. The DUR Board will limit presentations to ten (10) minutes, unless an extension is granted by the DUR Board.
The official meeting schedule, agenda and minutes of DUR Board meetings can be found at the Delaware Medicaid Pharmacy webpage, which also provides access to the DUR Board’s complete bylaws and a list of Board members. If you are unable to access any of these documents, please contact DMMA for a printed copy.
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