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pdfFFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
ABOUT THE SURVEY
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 Review (DUR) program. Such reports are
to include: descriptions of the nature and scope of the prospective and retrospective DUR programs;
a summary of the interventions used in retrospective DUR and an assessment of the education
program; a description of DUR Board activities; and an assessment of the DUR program’s impact on
quality of care as well as any cost savings generated by the program.
Note: Covered Outpatient Drugs (COD) are referenced throughout this survey and refers to
participating labelers in the Medicaid Drug Rebate Program (MDRP).
This report covers the period October 1, 2020 to September 30, 2021 and is due for submission to
CMS Central Office by no later than June 30, 2022. Answering the attached questions and
returning the requested materials as attachments to the report will constitute compliance with
the above-mentioned statutory requirement.
If you have any questions regarding the DUR Annual Report, please contact CMS via email at:
[email protected].
PRA DISCLOSURE STATEMENT (CMS-R-153)
This mandatory information collection (section 4401 of the Omnibus Budget Reconciliation Act of 1990 and section
1927(g) of the Social Security Act) is necessary to establish patient profiles in pharmacies, identify problems in
prescribing and/or dispensing, determine each program’s ability to meet minimum standards required for Federal
financial participation, and ensure quality pharmaceutical care for Medicaid patients. State Medicaid agencies that have
prescription drug programs are required to perform prospective and retrospective DUR in order to identify aberrations in
prescribing, dispensing and/or patient behavior. Under the Privacy Act of 1974 any personally identifying information
obtained will be kept private to the extent of the law. An agency may not conduct or sponsor, and a person is not required
to respond to, a collection of information unless it displays a currently valid Office of Management and Budget (OMB)
control number. The control number for this information collection request is 0938-0659 (Expires: 11/30/2022). Public
burden for all of the collection of information requirements under this control number is estimated at 64 hours per
response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden, to CMS, 7500 Security Boulevard, Attn: Paperwork Reduction Act Reports Clearance Officer,
Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.
I have read the information about this survey.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
I. DEMOGRAPHIC INFORMATION
State Abbreviation: _______
Medicaid Program Information
Identify state person responsible for DUR Annual Report Preparation.
First Name:
Last Name:
Email Address:
Area Code/Phone Number:
1. On a monthly average, how many of your state’s Medicaid beneficiaries are enrolled
in your state's Medicaid Fee-For-Service (FFS) program that have a pharmacy
benefit?
Beneficiaries
2. On a monthly average, how many of your state's Medicaid beneficiaries are enrolled
in managed care plan(s)?
Beneficiaries
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
II. PROSPECTIVE DUR (ProDUR)
1. Indicate the type of your pharmacy point of service (POS) vendor.
State-Operated
Contractor
Other
a. Vendor Name
b.
Who processes the state’s National Council for Prescription Drug Programs
(NCPDP) transactions?
POS vendor is the fiscal agent (FA)
POS vendor is a separate Pharmacy Benefits Manager (PBM)
None
2. Identify your ProDUR table driven criteria source. This would be initial ratings such
as drug to drug interactions, dose limits based on age and pregnancy severity. Check
all that apply.
First Databank
Medi-Span
Micromedex
Other, please specify ________________________________
3. When the pharmacist receives a ProDUR alert message that requires a pharmacist’s
review, does your system allow the pharmacist to override the alert using the “NCPDP
drug use evaluation codes” (reason for service, professional service and resolution)?
Yes
Varies by alert type
No
If “Yes” or “Varies by Alert Type,” check all that apply.
Alerts can be overridden ahead of time
Alerts can be overridden with standard professional codes
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
Alerts need prior authorization (PA) to be overridden
Other, please explain.
4. Does your state receive periodic reports providing individual pharmacy providers DUR
alert override activity in summary and/or in detail?
Yes
No
a. How often does your state receive reports?
Monthly
Quarterly
Annually
Ad hoc (on request)
Other, please explain.
b. If you receive reports, does your state follow up with those providers who
routinely override with interventions?
Yes
By what method does your state follow up?
Contact Pharmacy
Refer to Program Integrity for Review
Other, please explain.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
No, please explain.
5. Early Refill
a. At what percent threshold does your state set your system to edit?
i. Non-controlled drugs:
%
ii. Schedule II controlled drugs:
%
iii. Schedule III through V controlled drugs:
%
b. For non-controlled drugs:
When an early refill message occurs, does your state require a PA?
Yes
No
Dependent on medication or situation
If “Yes” or “Dependent on medication or situation,” who obtains
authorization?
Pharmacist
Prescriber
Pharmacist or Prescriber
If “No,” can the pharmacist override at the POS?
Yes
No
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
c. For controlled drugs:
When an early refill message occurs, does your state require a PA?
Yes
No
If “Yes,” who obtains authorization?
Pharmacist
Prescriber
Pharmacist or Prescriber
If “No,” can the pharmacist override at the POS?
Yes
No
6. When the pharmacist receives an early refill DUR alert message that requires the
pharmacist’s review, does your state’s policy allow the pharmacist to override for
situations such as:
Lost/stolen RX
Vacation
Overrides are only allowed by a pharmacist through a PA
Other, please explain.
7. Does your system have an accumulation edit to prevent patients from continuously
filling prescriptions early?
Yes
No
If “Yes,” please explain your edit.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
If “No,” does your state plan to implement this edit?
Yes
No
8. Does the state Medicaid program have any policy prohibiting the auto-refill process
that occurs at the POS (i.e. must obtain beneficiary's consent prior to enrolling in the
auto-refill program)?
Yes
No
9. For drugs not on your Preferred Drug List (PDL), does your Medicaid program have a
documented process (i.e. PA) in place, so that the Medicaid beneficiary or the Medicaid
beneficiary’s prescriber may access any covered outpatient drug when medically
necessary?
Yes
Please check all that apply.
Automatic PA based on diagnosis codes or systematic review
Trial and failure of first or second-line therapies
Pharmacist or technician reviews
Direct involvement with Pharmacy and/or Medical Director
Other, please explain.
No, please explain.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
a. Does your program provide for the dispensing of at least a 72-hour supply of a
covered outpatient drug (COD) in an emergency situation?
Yes
Please check all that apply.
Real-time automated process
Retrospective PA
Other process, please explain.
No, please explain.
10. Please list the requested data in each category in Table 1 – Top Drug Claims Data
Reviewed by the DUR Board below.
Column 1 – Top 10 PA Requests by Drug Name, report at generic ingredient level
Column 2 – Top 10 PA Requests by Drug Class
Column 3 – Top 5 Claim Denial Reasons (i.e. Quantity Limits (QL), Early Refill (ER),
PA, Therapeutic Duplications (TD), and Age Edits (AE))
Column 4 – Top 10 Drug Names by Amount Paid, report at generic ingredient level
Column 5 – From Data in column 4, determine the Percentage of Total Drug Spend
Column 6 – Top 10 Drug Names by Claim Count, report at generic ingredient level
Column 7 – From Data in Column 6, determine the Percentage of Total Claims
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
Table 1: Top Drug Claims Data Reviewed by the DUR Board
Column 1
Column 2
Column 3
Column 4
Column 5
Column 6
Column 7
Top 10 Prior Authorization (PA)
Requests by Drug Name, report at
generic ingredient level
Top 10 Prior Authorization
(PA) Requests by Drug Class
Top 5 Claim Denial Reasons (i.e.
Quantity Limits (QL), Early Refill (ER),
PA, Therapeutic Duplications (TD) and
Age Edits (AE))
Top 10 Drug Names by Amount Paid,
report at generic ingredient level
% of Total
Spent for
Drugs by
Amount Paid
(From data in
Column 4,
Determine the
% of total
drug spend)
Top 10 Drug Names by Claim Count,
report at generic ingredient level
Drugs by
Claim Count
% of Total
Claims
(From data in
Column 6,
Determine the
% of total
claims)
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
11. Section 1927(g) (A) of the Social Security Act (the Act) requires that the pharmacist
offer patient counseling at the time of dispensing. Who in your state has responsibilit y
for monitoring compliance with the oral counseling requirement? Check all that apply.
Medicaid Program
State Board of Pharmacy
Other, please explain.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
III. RETROSPECTIVE DUR (RetroDUR)
1. Indicate the type of vendor that performed your RetroDUR activities during the time
period covered by this report.
Company
Academic Institution
Other Institution
a. Identify, by name, your RetroDUR vendor.
b. Is the RetroDUR vendor the Medicaid Management Information System (MMIS)
fiscal agent?
Yes
No
c. Is the RetroDUR vendor the developer/supplier of your retrospective DUR criteria?
Yes
No
Please explain “Yes” or “No” response.
d. Does your state customize your RetroDUR vender criteria?
Yes
No
Ad hoc based on state-specific needs
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
2. How often does your state perform retrospective practitioner-based education?
Monthly
Bi-monthly
Quarterly
Other, please specify.
a. How often does your state perform retrospective reviews that involve
communication of client specific information to healthcare practitioners
(through messaging, fax, or mail)? Check all that apply.
Monthly
Bi-Monthly
Quarterly
Other, please specify.
b. What is the preferred mode of communication when performing RetroDUR
initiatives? Check all that apply.
Mailed letters
Provider phone calls
Near real-time fax
Near real-time messaging
Other new technologies such as apps or Quick Response (QR) codes
Focused workshops, case management, or WebEx training
Newsletters or other non-direct provider communications
Other, please specify _________
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
3. Summary 1 – RetroDUR Educational Outreach
RetroDUR Educational Outreach Summary should be a year-end report on
retrospective screening and educational interventions. The summary should be limited
to the most prominent problems with the largest number of exceptions. The results of
RetroDUR screening and interventions should be included and detailed below.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
IV. DUR BOARD ACTIVITY
1. Does your state have an approved Medication Therapy Management (MTM)
Program?
Yes
No
Summary 2 – DUR Board Activities
DUR Board Activities Summary should include a brief descriptive on DUR activities
during the fiscal year reported. This summary should:
•
Indicate the number of DUR Board meetings held.
•
List additions/deletions to DUR Board approved criteria:
o For ProDUR, list problem type/drug combinations added or deleted.
o For RetroDUR, list therapeutic categories added or deleted.
•
Describe Board policies that establish whether and how results of ProDUR
screening are used to adjust RetroDUR screens.
•
Describe policies that establish whether and how results of RetroDUR screening
are used to adjust ProDUR screens.
•
Describe DUR Board involvement in the DUR education program (i.e. newsletters,
continuing education, etc.).
•
Describe policies adopted to determine the mix of patient or provider specific
intervention types (i.e. letters, face-to-face visits, increased monitoring).
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
V. PHYSICIAN ADMINISTERED DRUGS (PAD)
The Deficit Reduction Act required collection of national drug code (NDC) numbers for
covered outpatient physician administered drugs. These drugs are paid through the
physician and hospital programs. Has your MMIS been designed to incorporate this data
into your DUR criteria for:
1. ProDUR?
Yes
No
If “No,” does your state have a plan to include this information in your DUR
criteria in the future?
Yes
No
2. RetroDUR?
Yes
No
If “No,” does your state have a plan to include this information in your DUR
criteria in the future?
Yes
No
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
VI. GENERIC POLICY AND UTILIZATION DATA
Summary 3 – Generic Drug Substitution Policies
Generic Drug Substitution Policies should summarize factors that could affect your
generic utilization percentage. In describing these factors, please explain any
formulary management or cost containment measures, preferred drug list (PDL)
policies, educational initiatives, technology or promotional factors, or other state
specific factors that affects your generic utilization rate.
1. In addition to the requirement that the prescriber write in his own handwriting “Brand
Medically Necessary” for a brand name drug to be dispensed in lieu of the generic
equivalent, does your state have a more restrictive requirement?
Yes
No
If “Yes,” check all that apply.
Require that a MedWatch Form be submitted
Require the medical reason(s) for override accompany the prescription(s)
Prior authorization (PA) is required
Other, please explain.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
Table 2: Generic Drug Utilization Data
Computation Instructions
KEY
Single Source (S) – Drugs having an FDA New Drug Application (NDA), and
there are no generic alternatives available on the market.
Non-Innovator Multiple-Source (N) – Drugs that have an FDA Abbreviated New
Drug Application (ANDA), and generic alternatives exist on the market.
Innovator Multiple-Source (I) – Drugs which have an NDA and no longer have
patent exclusivity.
1. Generic Utilization Percentage: To determine the generic utilization percentage
of all covered outpatient drugs paid during this reporting period, use the following
formula:
N ÷ (S + N + I) × 100 = Generic Utilization Percentage
2. Generic Expenditures Percentage of Total Drug Expenditures: To determine
the generic expenditure percentage (rounded to the nearest $1000) for all covered
outpatient drugs for this reporting period use the following formula:
$N ÷ ($S + $N + $I) × 100 = Generic Expenditure Percentage
CMS has developed an extract file from the Medicaid Drug Rebate Program Drug Product Data File
identifying each NDC along with sourcing status of each drug: S, N, or I, which can be found at
Medicaid.gov (Click on the link “National Drug Code and Drug Category file [ZIP],” then open the
Medicaid Drug Product File 4th Qtr. Excel file).
Please provide the following utilization data for this DUR reporting period for all covered
outpatient drugs paid. Exclude Third Party Liability (TPL).
Single Source (S)
Drugs
Total Number of Claims
Total Reimbursement
Amount Less Co-Pay
Non-Innovator (N)
Drugs
Innovator Multi-Source (I)
Drugs
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
2. Indicate the generic utilization percentage for all covered outpatient drugs (COD) paid
during this reporting period, using the computation instructions in Table 2 – Generic
Drug Utilization Data.
Number of Generic Claims:
__________________
Total Number of Claims:
__________________
Generic Utilization Percentage: __________________%
3. How many multi-source drugs have the innovator as the preferred drug product based
on net pricing (brand preferred over generic)?
____________
4. Indicate the percentage dollars paid for generic CODs in relation to all COD claims
paid during this reporting period using the computation instructions in Table 2:
Generic Drug Utilization Data.
Generic Dollars:
$_________________
Total Dollars:
$_________________
Generic Expenditure Percentage: __________________%
5. Does your state have any policies related to Biosimilars? Please explain.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
VII.
PROGRAM EVALUATION/COST SAVINGS/COST AVOIDANCE
1. Did your state conduct a DUR program evaluation of the estimated cost savings/cost
avoidance?
Yes
No
If “Yes,” identify, by name and type, the institution that conducted the program
evaluation.
Institution Type
Company
Academic Institution
Other Institution
Institution Name
2. Please provide your ProDUR and RetroDUR program cost savings/cost avoidance in
the chart below.
Cost in Dollars
ProDUR Total Estimated Avoided Costs
RetroDUR Total Estimated Avoided Costs
Other Cost Avoidance
Grand Total Estimated Avoided Costs
3. The Estimated Percent Impact was generated by dividing the Grand Total Estimated
Avoided Costs from Question 2 above by the Total Dollar Amount provided in Section
VI, Question 5, then multiplying this value by 100.
Estimated Percent Impact:
__________________%
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
4. Summary 4 – Cost Savings/Cost Avoidance Methodology
Cost Savings/Cost Avoidance Methodology Summary should include program
evaluations/cost savings estimates prepared by the state or contractor. Please provide
detailed summary below.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
VIII.
A.
FRAUD WASTE, AND ABUSE DETECTION
LOCK-IN or PATIENT REVIEW AND RESTRICTION PROGRAMS
1. Does your state have a documented process in place that identifies potential fraud or
abuse of controlled drugs by beneficiaries?
Yes
No
If “Yes,” what actions does this process initiate? Check all that apply:
Deny claims
Require prior authorization (PA)
Refer to Lock-In Program
Refer to Program Integrity Unit (PIU) and/or Surveillance Utilization Review
(SUR) Unit for audit/investigation
Refer to Office of Inspector General (OIG)
Other, please explain.
2. Does your state have a Lock-In program for beneficiaries with potential misuse or
abuse of controlled substances?
Yes
No
If “Yes,” please continue.
a. What criteria does your state use to identify candidates for Lock-In? Check all
that apply:
Number of controlled substances (CS)
Different prescribers of CS
Multiple pharmacies
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
Days’ supply of CS
Exclusivity of short acting opioids
Multiple emergency room (ER) visits
Prescription drug monitoring program (PDMP) data
Other, please explain.
b. Does your state have the capability to restrict the beneficiary to:
i) Prescriber only
Yes
No
ii) Pharmacy only
Yes
No
iii) Prescriber and pharmacy
Yes
No
c. What is the usual Lock-In time period?
12 months
18 months
As determined by the state on a case-by-case basis
Lock-in time period is based on number of incidences/occurrences
Other, please explain.
24 months
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
d. On average, what percentage of the FFS population is in Lock-In status
annually?
%
e. Please provide an estimate of the savings attributed to the Lock-In program for
the fiscal year under review.
$
3. Does your state have a documented process in place that identifies possible FWA of
controlled drugs by prescribers?
Yes
What actions does this process initiate? Check all that apply:
Deny claims written by this prescriber
Refer to Program Integrity Unit (PIU) and/or Surveillance Utilizat ion
Review (SUR) Unit for audit/investigation
Refer to the appropriate Medical Board
Other, please explain.
No, please explain.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
4. Does your state have a documented process in place that identifies potential FWA of
controlled drugs by pharmacy providers?
Yes
What actions does this process initiate? Check all that apply:
Deny claim
Refer to Program Integrity Unit (PIU) and/or Surveillance Utilization Review
(SUR) Unit for audit/investigation
Refer to Board of Pharmacy
Other, please explain.
No, please explain.
5. Does your state have a documented process in place that identifies and/or prevents
potential FWA of non-controlled drugs by beneficiaries, prescribers, and pharmacy
providers?
Yes
Please explain your program for FWA of non-controlled substances.
No, please explain.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
B.
PRESCRIPTION DRUG MONITORING PROGRAM (PDMP)
Note: Section 5042 of the SUPPORT for Patients and Communities Act requires states to
report metrics in reference to their state’s PDMP. CMS has included questions to
reference these metrics to help your state establish processes to be in compliance with
provisions outlined in Section 5042 and CMS reporting, beginning in FFY 2023. Please
complete applicable questions below in this section of the survey.
1. Does your Medicaid program have the ability to query the state’s PDMP database?
Yes, receive PDMP data
Daily
Monthly
Other
Weekly
Yes, have direct access to the database
Can query by client
Can query by dispensing entity
Can query by prescriber
No, please explain.
If “Yes,” please continue.
a. Please explain how the state applies this information to control FWA of
controlled substances.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
b. Does your state also have access to Border States’ PDMP information?
Yes
No
c. Does your state also have PDMP data integrated into your point of sale (POS)
edits?
Yes
No
2. Does your state or your professional board require prescribers to access the PDMP
patient history before prescribing controlled substances?
Yes
No, please explain.
If “Yes,” please continue.
a. Are there protocols involved in checking the PDMP?
Yes, please explain.
No
b. Are providers required to have protocols for responses to information from the
PDMP that is contradictory to the direction that the practitioner expects from
the client?
Yes
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
No
c. If a provider is not able to conduct PDMP check, does your state require the
prescriber to document a good faith effort, including the reasons why the
provider was not able to conduct the check?
Yes
No, please explain.
If “Yes,” does your state require the provider to submit, upon request,
documentation to the State?
3.
Yes
No, please explain.
Does your State or professional board require pharmacists to check the PDMP
prior to dispensing?
Yes
No, please explain.
If “Yes,” are there protocols involved in checking the PDMP?
Yes, please explain.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
No
4. In the State’s PDMP system, which of the following pieces of information with
respect to a beneficiary is available to prescribers as close to real-time as possible?
Check all that apply.
PDMP drug history
The number and type of controlled substances prescribed to and dispensed
to the beneficiary during at least the most recent 12-month period
The name, location, and contact information, or other identifying number,
such as a national provider identifier, for previous beneficiary fills
Other, please explain.
a. Are there barriers that hinder the Medicaid agency from fully accessing the
PDMP that prevent the program from being utilized the way it was intended
to be to curb FWA?
Yes, please explain the barriers (i.e. lag time in prescription data being
submitted, prescribers not accessing, pharmacists unable to view
prescription history before filling script).
No
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
5. (Optional) Please specify below the following information for the 12-month
reporting period for this survey. Note: Mandatory reporting will be required in
FFY2023 under section 1927(g)(3)(D) of the Act.
a. The percentage of covered providers who checked the prescription drug history
of a beneficiary through a PDMP before prescribing a controlled substance to
such an individual:
%
b. Average daily morphine milligram equivalent (MME) prescribed for controlled
substances per covered individuals:
MME
c. Average daily MME prescribed for controlled substances per covered
individuals who are receiving opioids.
MMEs
d. Please complete Tables 3, 4, 5 and 6 below. Specify the controlled substances
prescribed based on prescriptions dispensed (by generic ingredient(s)) and
within each population during this 12-month FFY reporting period.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
Table 3: Opioid Controlled Substances by Population
Population
0-18 yrs.
19-29 yrs.
30-39 yrs.
40-49 yrs.
50-59 yrs.
60-69 yrs.
70-79 yrs.
80+ yrs.
Individuals with
Disabilities Utilizing
State Eligibility
Categories
Column 1
Total Number
of Beneficiaries
Within Each
Age Group
Column 2
Total Number of Unique
Beneficiaries Within Each Age
Group Receiving an Opioid
Controlled Substance in the 12
Month Reporting Period
Column 3Column 3
Percentage of Unique Beneficiaries
Within Each Age Group Receiving
an Opioid Controlled Substance in
the 12 Month Reporting Period
Column 4
Top 3 Opioid Controlled
Substances Received Within Each
Age Group (Generic Ingredient) in
the 12 Month Reporting Period
Column 5
Number of Unique Beneficiaries
Within Each Age Group Receiving
the Opioid Controlled Substance
(Specified in Column 4) in the 12
Month Reporting Period
Column 6
Percentage of Unique Beneficiaries
Within Each Age Group Receiving
the Top 3 Opioid Controlled
Substances (Specified in Column 4)
in the 12 Month Reporting Period
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
Table 4: Top Sedative/Benzodiazepines Controlled Substances by Population
When listing the controlled substances in different drug categories, for the purpose of Table 4 below, please consider long and short acting benzodiazepines to be in the same category.
Population
0-18 yrs.
19-29 yrs.
30-39 yrs.
40-49 yrs.
50-59 yrs.
60-69 yrs.
70-79 yrs.
80+ yrs.
Individuals with
Disabilities Utilizing
State Eligibility
Categories
Column 1
Total Number
of Beneficiaries
Within Each
Age Group
Column 2Column 2
Total Number of Unique
Beneficiaries Within Each Age
Group Receiving a
Sedative/Benzodiazepine in the 12
Month Reporting Period
Column 3Column 3
Percentage of Unique Beneficiaries
Within Each Age Group Receiving
a Sedative/Benzodiazepine in the 12
Month Reporting Period
Column 4
Sedative/Benzodiazepine Received
Within Each Age Group (Generic
Ingredient) in the 12 Month
Reporting Period
Column 5
Number of Unique Beneficiaries
Within Each Age Group Receiving
the Sedative/Benzodiazepine
(Specified in Column 4) in the 12
Month Reporting Period
Column 6
Percentage of Unique Beneficiaries
Within Each Age Group Receiving
the Top 3 Sedative/Benzodiazepine
(Specified in Column 4) in the 12
Month Reporting Period
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Table 5: Top Stimulant/ADHD Controlled Substances by Population
When listing the controlled substances in different drug categories , please consider long and short acting ADHD medications to be in the same category.
Population
0-18 yrs.
19-29 yrs.
30-39 yrs.
40-49 yrs.
50-59 yrs.
60-69 yrs.
70-79 yrs.
80+ yrs.
Individuals with
Disabilities Utilizing
State Eligibility
Categories
Column 1
Total Number
of Beneficiaries
Within Each
Age Group
Column 2
Total Number of Unique
Beneficiaries Within Each Age
Group Receiving a
Stimulant/ADHD Controlled
Substance in the 12 Month
Reporting Period
Column 3
Percentage of Unique Beneficiaries
Within Each Age Group Receiving
a Stimulant/ADHD Controlled
Substance in the 12 Month
Reporting Period
Column 4
Top 3 Stimulant/ADHD Controlled
Substances Received Within Each
Age Group (Generic Ingredient) in
the 12 Month Reporting Period
Column 5
Number of Unique Beneficiaries
Within Each Age Group Receiving
the Stimulant/ADHD Controlled
Substance (Specified in Column 4)
in the 12 Month Reporting Period
Column 6
Percentage of Unique Beneficiaries
Within Each Age Group Receiving
the Top 3 Stimulant/ADHD
Controlled Substance (Specified in
Column 4) in the 12 Month
Reporting Period
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Table 6: Populations on 2 or more Controlled Substances in Different Drug Categories
When listing the controlled substances in different drug categories, for the purpose of Table 6 below, please consider long and short acting opioids to be in the same category. Please follow this approach for long
and short acting ADHD medications and benzodiazepines in this table as well. Please note, Column 2 and Column 4 are requesting an average monthly value based on the 12 month reporting period.
Population
0-18 yrs.
19-29 yrs.
30-39 yrs.
40-49 yrs.
50-59 yrs.
60-69 yrs.
70-79 yrs.
80+ yrs.
Individuals with Disabilities
Utilizing State Eligibility
Categories
Column 1
Total Number of
Beneficiaries within Each
Age Group
Column 2
Number of Unique Beneficiaries in Each
Age Group/Month Receiving 2 or more
Controlled Substances in Different Drug
Categories per Month Averaged for the
12 Month Reporting Period
Column 3
Percentage of Age Group Receiving 2 or
More Controlled Substances per Month
Averaged for the 12 Month Reporting
Period
Column 4
Number of Unique Beneficiaries in Each
Age Group Receiving 3 or more
Controlled Substances in Different Drug
Categories per Month Averaged for the
12 Month Reporting Period
Column 5
Percentage of Age Group Receiving 3 or
more Controlled Substances per Month
Averaged for the 12 Month Reporting
Period
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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i.
If there is additional information you want to provide for the previous 12month reporting period, please explain below or specify N/A if not
applicable.
ii.
If any of the information requested is not being reported above, please
explain below or specify N/A if not applicable.
6. Have you had any changes to your state’s PDMP during this reporting period that
have improved the Medicaid program’s ability to access PDMP data?
Yes, please explain.
No
7. In this reporting period, have there been any data or privacy breaches of the PDMP
or PDMP data?
Yes
No
If “Yes,” please summarize the breach, the number of individuals impacted, a
description of the steps the State has taken to address each such breach, and if law
enforcement or the affected individuals were notified of the breach.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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C.
OPIOIDS
1. Does your state currently have a POS edit in place to limit the days’ supply dispensed
of an initial opioid prescription for opioid naïve patients?
Yes, for all opioids
Yes, for some opioids
No
Please explain response above
If the answer to question 1 is “Yes, for all opioids” or “Yes, for some opioids,” please
continue.
a. What is the maximum number of days allowed for an initial opioid prescription
for an opioid naïve patient?
# of days
b. Does your state have POS edits in place to limit days’ supply of subsequent opioid
prescriptions ? If yes, please indicate your days supply limit.
24-day supply
30-day supply
34-day supply
Other________
No
90-day supply
Please explain above response.
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2. Does your state have POS edits in place to limit the quantity dispensed of shortacting (SA) opioids?
Yes, please specify limit. _____# of units
Other, please explain.
No, please explain.
3. Does your state currently have POS edits in place to limit the quantity dispensed of
long-acting (LA) opioids?
Yes, please specify limit. _____# of units
Other, please explain.
No, please explain.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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4. Does your state have measures other than restricted quantities and days’ supply in
place to either monitor or manage the prescribing of opioids?
Yes
No
If “Yes,” check all that apply.
Pharmacist override
Deny claim and require PA
Intervention letters
MME daily dose program
Step therapy or clinical criteria
Requirement that patient has a pain management contract or PatientProvider agreement
Requirement that prescriber has an opioid treatment plan for patients
Require documentation of urine drug screening results
Require diagnosis
Require PDMP checks
Workgroups to address opioids
Other, please specify.
Please provide details on these opioid prescribing controls in place.
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If “No,” please explain what you do in lieu of the above or why you do not have
measures in place to either manage or monitor the prescribing of opioids.
5. Does your state have POS edits to monitor duplicate therapy of opioid
prescriptions? This excludes regimens that include a single extended-release
product and a breakthrough short acting agent?
Yes
No
Please explain above response.
6.
6. Does your state have POS edits to monitor early refills of opioid prescriptions
dispensed?
Yes
No
Please explain answer above.
7. Does your state have comprehensive automated retrospective claim reviews to
monitor opioid prescriptions exceeding these state limitations (early refills,
duplicate fills, quantity limits and days’ supply)?
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Yes, please explain in detail scope, nature, and frequency of these retrospective
reviews.
No, please explain.
8. Does your state currently have POS edits in place or automated retrospective claim
reviews to monitor opioids and benzodiazepines being used concurrently?
Yes, POS edits
Yes, automated retrospective claim reviews
Yes, both POS edits and automated retrospective claim reviews
Please explain above response and detail the scope and nature of these reviews and
edits. Additionally, please explain any potential titration processes utilized for
those patients chronically on benzodiazepines and how the state justifies pain
medications, i.e. Oxycodone/APAP, for breakthrough pain without jeopardizing
patient care (i.e. quantity limits/practitioner education titration programs).
No, please explain.
9. Does your state currently have POS edits in place or automated retrospective claim
reviews to monitor opioids and sedatives being used concurrently?
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Yes, POS edits
Yes, automated retrospective claim reviews
Yes, both POS edits and automated retrospective claim reviews
Please explain response above and detail scope and nature of reviews and edits.
No, please explain.
10. Does your state currently have POS edits in place or automated retrospective claim
reviews to monitor opioids and antipsychotics being used concurrently?
Yes, POS edits only
Yes, automated retrospective claim reviews
Yes, both POS edits and automated retrospective claim reviews
Please explain in detail scope and nature of reviews and edits.
No, please explain.
11. Does your state have POS safety edits or perform automated retrospective claim
reviews and/or provider education in regard to beneficiaries with a diagnosis history
of opioid use disorder (OUD) or opioid poisoning diagnosis (check all that apply)?
Yes, POS edits
Yes, automated retrospective claim reviews
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Yes, provider education
No
If “Yes, automated retrospective claim reviews and/or “provider education,”
please indicate how often.
Monthly
Quarterly
Annually
Ad hoc
Semi-Annually
Other, please specify.
Please explain the nature and scope of edits, reviews and/or provider education
reviews performed.
If “No,” does your state plan on implementing POS edits, automated retrospective
claim reviews and/or provider education in regard to beneficiaries with a diagnosis
history of OUD or opioid poisoning in the future?
Yes, when does your state plan on implementing?
No, please explain.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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12. Does your state Medicaid program develop and provide prescribers with pain
management or opioid prescribing guidelines?
Yes
No
If “Yes,” please check all that apply.
Your state Medicaid program refers prescribers to the Center for Disease
Control (CDC) Guideline for Prescribing Opioids for Chronic Pain.
Other guidelines, please identify.
If “No,” please explain why no guidelines are offered.
13. Does your state have a drug utilization management strategy that supports abuse
deterrent opioid use to prevent opioid misuse and abuse (i.e. presence of an abuse
deterrent opioid with preferred status on your preferred drug list)?
Yes, please explain.
No
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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14. Were there COVID-19 ramifications on edits and reviews on controlled
substances during the public health emergency?
Yes, please explain.
No
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D.
MORPHINE MILLIGRAM EQUIVALENT (MME) DAILY DOSE
1. Have you set recommended maximum MME daily dose measures?
Yes
No
If “Yes,” please continue.
a. What is your maximum morphine equivalent daily dose limit in milligrams?
Less than 50 MME, please specify: _________mg per day
50 MME
70 MME
80 MME
90 MME
100 MME
120 MME
200 MME
Greater than 200 MME, please specify.
mg per day
Other, please specify.________ mg per day
b. Please explain nature and scope of dose limit (i.e. Who does the edit apply to?,
Does the limit apply to all opioids?, Are you in the process of tapering patients
to achieve this limit?).
If “No,” please explain the measure or program you utilize.
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2. Does your state have an edit in your POS system that alerts the pharmacy provider that
the MME daily dose prescribed has been exceeded?
Yes
No
If “Yes,” does your state require PA if the MME limit is exceeded?
Yes
No
3. Does your state have automated retrospective claim reviews to monitor the MME total
daily dose of opioid prescriptions dispensed?
Yes
No
Please explain.
4. Do you provide information to your prescribers on how to calculate the MME daily
dosage or do you provide a calculator developed elsewhere?
Yes
No
If “Yes,” please continue.
a. Please name the developer of the calculator:
CDC
Academic Institution
Other, please specify.
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b. How is the information disseminated? Check all that apply.
Website
Provider notice
Educational seminar
Other, please explain.
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E.
OPIOID USE DISORDER (OUD) TREATMENT
1. Does your state have utilization controls (i.e. preferred drug list (PDL), prior
authorization (PA), quantity limit (QL)) to either monitor or manage the prescribing of
Medication Assisted Treatment (MAT) drugs for OUD?
Yes, please explain.
No
2. Does your Medicaid program set total mg per day limits on the use of buprenorphine
and buprenorphine/naloxone combination drugs?
Yes
No
If “Yes,” please specify the total mg/day:
12 mg
24 mg
32 mg
16 mg
Other, please explain.
3. What are your limitations on the allowable length of this treatment?
No limit
3 months or less
6 months
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12 months
Other, please explain.
24 months
4. Does your state require that the maximum mg per day allowable be reduced after a set
period of time?
Yes
No
If “Yes,” please continue.
a. What is your reduced (maintenance) dosage?
8 mg
12 mg
Other, please explain.
16 mg
b. What are your limitations on the allowable length of the reduced dosage
treatment?
No limit
12 months
Other, please explain.
6 months
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5. Does your state have at least one buprenorphine/naloxone combination product
available without PA?
Yes
No
6. Does your state currently have edits in place to monitor opioids being used concurrently
with any buprenorphine drug or any form of MAT?
Yes
No
Other, please explain.
If “Yes,” can the POS pharmacist override the edit?
Yes
No
7. Is there at least one formulation of naltrexone for OUD available without PA?
Yes
No
8. Does your state have at least one naloxone opioid overdose product available without
PA?
Yes
No
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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9. Does your state retrospectively monitor and manage appropriate use of naloxone to
persons at risk of overdose?
Yes
No, please explain.
10. Does your State Board of Professional Regulations/Board of Pharmacy/Board of
Medicine and/or state Medicaid program allow pharmacists to dispense naloxone
prescribed independently or by collaborative practice agreements, standing orders, or
other predetermined protocols?
Yes, State Board of Professional Regulations/Board of Pharmacy/Board of
Medicine and/or state Medicaid program under protocol
Yes, prescribed independently
No
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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F.
OUTPATIENT TREATMENT PROGRAMS (OTP)
1. Does your state cover OTPs that provide Behavioral Health (BH) and MAT services?
Yes
No, please explain.
If “Yes”, is a referral needed for OUD treatment through OTPs?
Yes
No
Please explain.
2. Does your state Medicaid program cover buprenorphine or buprenorphine/naloxone
for diagnoses of OUD as part of a comprehensive MAT treatment plan through
OTPs?
Yes
No, please explain.
3. Does your state Medicaid program cover naltrexone for diagnoses of OUD as part of
a comprehensive MAT treatment plan?
Yes
No, please explain.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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4. Does your state Medicaid program cover Methadone for a substance use disorder (i.e.
OTPs, Methadone Clinics)?
Yes
No
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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G.
PSYCHOTROPIC MEDICATION
ANTIPSYCHOTICS
1. Does your state currently have restrictions in place to limit the quantity of antipsychotic
drugs?
Yes
No
Please explain restrictions or N/A.
2. Does your state have a documented program in place to either manage or monitor the
appropriate use of antipsychotic drugs in children?
Yes
No
If “Yes,” please continue.
a. Does your state either manage or monitor:
Only children in foster care
Other, please explain.
All children
b. Does your state have edits in place to monitor (check all that apply):
Child’s age, please specify age limit: _______years
Dosage
Indication
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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Polypharmacy
Other, please explain.
c. Please briefly explain the specifics of your documented antipsychotic
monitoring program(s).
If “No,” please continue.
Does your state plan on implementing an antipsychotic monitoring program in the
future?
Yes, please specify when you plan on implementing a program to monitor the
appropriate use of antipsychotic drugs in children.
No, please explain why you will not be implementing a program to monitor
the appropriate use of antipsychotic drugs in children.
STIMULANTS
3. Does your state currently have restrictions in place to limit the quantity of stimulant
drugs?
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Yes
No
4. Does your state have a documented program in place to either manage or monitor the
appropriate use of stimulant drugs in children?
Yes
No
If “Yes,” please continue.
a. Does your state either manage or monitor:
Only children in foster care
All children
Other, please explain.
b. Does your state have edits in place to monitor (check all that apply):
Child’s age, please specify age limit: _______years
Dosage
Indication
Polypharmacy
Other, please explain.
c. Please briefly explain the specifics of your documented stimulant monitorin g
program(s).
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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If “No,” please continue.
Does your state plan on implementing a stimulant monitoring program in the
future?
Yes, please specify when you plan on implementing a program to monitor
the appropriate use of stimulant drugs in children.
No, please explain why you will not be implementing a program to monitor
the appropriate use of stimulant drugs in children.
ANTIDEPRESSANTS
5. Does your state have a documented program in place to either manage or monitor the
appropriate use of antidepressant drugs in children?
Yes
No
If “Yes,” please continue.
a. Does your state either manage or monitor:
Only children in foster care
All children
Other, please explain.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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b. Does your state have edits in place to monitor (check all that apply):
Child’s age, please specify age limit: _______years
Dosage
Indication
Polypharmacy
Other, please explain.
c. Please briefly explain the specifics of your documented antidepressant
monitoring program(s).
If “No,” please continue.
Does your state plan on implementing an antidepressant monitoring program
in the future?
Yes, please specify when you plan on implementing a program to monitor the
appropriate use of antidepressant drugs in children.
No, please explain why you will not be implementing a program to monitor
the appropriate use of antidepressant drugs in children.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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MOOD STABILIZERS
6. Does your state have a documented program in place to either manage or monitor the
appropriate use of mood stabilizing drugs in children?
Yes
No
If “Yes,” please continue.
a. Does your state either manage or monitor:
Only children in foster care
All children
Other, please explain.
b. Does your state have edits in place to monitor (check all that apply):
Child’s age, please specify age limit: _______
Dosage
Indication
Polypharmacy
Other, please explain.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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c. Please briefly explain the specifics of your documented mood stabilizer
monitoring program(s).
If “No,” please continue.
Does your state plan on implementing a mood stabilizer monitoring program in
the future?
Yes, please specify when you plan on implementing a program to monitor the
appropriate use of mood stabilizing drugs in children.
No, please explain why you will not be implementing a program to monitor
the appropriate use of a mood stabilizing drugs in children.
ANTIANXIETY/SEDATIVES
7. Does your state have a documented program in place to either manage or monitor the
appropriate use of antianxiety/sedative drugs in children?
Yes
No
If “Yes,” please continue.
a. Does your state either manage or monitor:
Only children in foster care
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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All children
Other, please explain.
b. Does your state have edits in place to monitor (check all that apply):
Child’s age, please specify age limit: _______
Dosage
Indication
Polypharmacy
Other, please explain.
c. Please briefly explain the specifics of your documented antianxiety/sedative
monitoring program(s).
If “No,” please continue.
Does your state plan on implementing an antianxiety/sedative monitoring program
in the future?
Yes, please specify when you plan on implementing a program to monitor the
appropriate use of antianxiety/sedative drugs in children.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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No, please explain why you will not be implementing a program to monitor
the appropriate use of antianxiety/sedative drugs in children.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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IX. INNOVATIVE PRACTICES
1. Does your state participate in any demonstrations or have any waivers to allow
importation of certain drugs from Canada or other countries that are versions of FDAapproved drugs for dispensing to Medicaid beneficiaries?
Yes, please explain.
No
2. Summary 5 – Innovative Practices
Innovative Practices Summary should discuss development of innovative practices
during the past year (i.e. Substance Use Disorder, Hepatitis C, Cystic Fibrosis, MME,
and Value Based Purchasing). Please describe in detailed narrative below any
innovative practices that you believe have improved the administration of your DUR
program, the appropriateness of prescription drug use and/or have helped to control
costs (i.e., disease management, academic detailing, automated PA, continuing
education programs).
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
X. MANAGED CARE ORGANIZATIONS (MCOs)
1. How many MCOs are enrolled in your state Medicaid program?
____________MCO(s) (Insert the number of MCOs in the space provided including
0 if none)
If “Zero” or “None”, please skip the rest of this section.
2. Is your pharmacy program included in the capitation rate (carved in)?
Yes
No
Partial
Please specify the drug categories that are carved out.
3. Contract updates between state and MCOs addressing DUR provisions in Section 1004
Support for Patients and Communities Act are required based on 1902(oo). If covered
outpatient drugs are included in an MCO’s covered benefit package, has the State
updated their MCOs’ contracts for compliance with Section 1004 of the SUPPORT for
Patients and Communities Act?
Yes, contracts are updated to address each provision. Please specify effective date:
_____________
No, contracts are not updated, please explain.
a. Is the state complying with Federal law and monitoring MCO compliance on
the SUPPORT for Patients and Communities Act provisions?
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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Yes, state is complying with Federal law and monitoring MCO compliance
on SUPPORT for Patients and Communities Act provisions. Please
explain monitoring activities.
No, please explain.
4. Does the state set requirements for the MCO’s pharmacy benefit (i.e. same preferred
drug list, same ProDUR/RetroDUR)?
Yes
No
If “Yes,” please continue.
a. Please check all requirements that apply below:
Formulary Reviews
Same PDL
Same ProDUR
Same RetroDUR
No state PDL
b. Please briefly explain your policy.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
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If “No,” does your state plan to set standards in the future?
Yes
No, please explain.
5. Is the RetroDUR program operated by the state or by the MCOs or does your state use
a combination of state interventions as well as individual MCO interventions?
State operated
MCO operated
State uses a combination of state interventions as well as individual MCO
interventions
6. Indicate how the State oversees the FFS and MCO RetroDUR programs? Please
explain oversight process.
7. How does the state ensure MCO compliance with DUR requirements described in
Section 1927(g) of the Act and 42 CFR part 456, subpart K?
8. Did all of your managed care plans submit their DUR reports?
Yes
No, please explain.
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS)
DRUG UTILIZATION REVIEW (DUR) ANNUAL SURVEY
XI. EXECUTIVE SUMMARY
Executive Summary should provide a brief overview of your program. It should describe
FFY 2021 highlights of the program, FFS initiatives, improvements, program oversight of
managed care partners when applicable, and statewide (FFS and MCO) initiatives.
| File Type | application/pdf |
| File Title | FFY 2021 MEDICAID FEE-FOR-SERVICE (FFS) |
| Author | MICHAEL FORMAN |
| File Modified | 2021-11-29 |
| File Created | 2021-08-17 |