Health, Health Care Financing, Coverage and Reimbursement Policy

Rule R414-60A

Drug Utilization Review Board

Five-Year Notice of Review and Statement of Continuation

DAR File No.: 36406
Filed: 06/25/2012 05:07:52 PM

NOTICE OF REVIEW AND STATEMENT OF CONTINUATION

Concise explanation of the particular statutory provisions under which the rule is enacted and how these provisions authorize or require the rule:

This rule is authorized under Section 26-18-102, which sets forth the policies, procedures, and organization of the Drug Utilization Review (DUR) Board. In addition, 42 CFR 456.716 requires the Department to establish and organize a DUR Board to include health care professionals with recognized knowledge and expertise.

Summary of written comments received during and since the last five-year review of the rule from interested persons supporting or opposing the rule:

The Department received a comment as to why it filed this new rule when the DUR Board already existed at the time of the rule filing. The Department responded that it filed this new rule to distinguish between the Pharmacy and Therapeutics Committee that it established to oversee the Preferred Drug List during that same time period, and to clarify DUR committee meeting times, procedures, and member appointments.

Reasoned justification for continuation of the rule, including reasons why the agency disagrees with comments in opposition to the rule, if any:

This rule is necessary because it implements the composition and membership requirements of the DUR Board to provide medically necessary and cost effective services for Medicaid recipients. This rule also spells out the functions of board members to carry out their responsibilities for the Medicaid drug program. Therefore, this rule should be continued.

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Direct questions regarding this rule to:

• Craig Devashrayee at the above address, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at cdevashrayee@utah.gov

Authorized by:

David Patton, Executive Director

Effective:

06/25/2012