Utah Administrative Code

The Utah Administrative Code is the body of all effective administrative rules as compiled and organized by the Division of Administrative Rules (see Subsection 63G-3-102(5); see also Sections 63G-3-701 and 702).

NOTE: For a list of rules that have been made effective since August 1, 2019, please see the codification segue page.

NOTE TO RULEFILING AGENCIES: Use the RTF version for submitting rule changes.


R414. Health, Health Care Financing, Coverage and Reimbursement Policy.

Rule R414-60A. Drug Utilization Review Board.

As in effect on August 1, 2019

Table of Contents

R414-60A-1. Introduction and Authority.

(1) The Drug Utilization Review Board (DURB) aids in pharmacy policy oversight and drug utilization.

(2) The DURB is authorized under 42 CFR 456.716 and Sections 26-18-2, 3, and 102.

R414-60A-2. DURB Composition and Membership Requirements.

(1) The Director of the Division of Medicaid and Health Financing (DMHF) shall act on behalf of the Executive Director of the Utah Department of Health regarding all DURB issues, and shall appoint membership to the DURB in accordance with Section 26-18-102. In addition, the Director shall appoint one pharmacist from recommendations received from the Accountable Care Organizations (ACOs).

(2) Membership Requirements.

(a) An appointee may not serve more than two consecutive terms in one of the board positions listed in Section 26-18-102. Terms separated by an interruption of more than two months are not consecutive.

(b) If DMHF does not receive recommendations to fill a vacant position within 30 days of a request, DMHF may appoint a qualified individual to fill the vacancy.

(c) If there are no willing nominees for appointment when an appointed term has expired, the DMHF Director may reappoint members on the board to additional non-consecutive terms as needed.

(3) When a vacancy occurs on the board, the Director shall appoint a replacement for the unexpired term of the vacating member.

(4) DURB members serve at the discretion of the DMHF Director.

(5) The DURB shall be managed by a non-voting board manager appointed from the pharmacy group within DMHF.

(6) Other individuals of the DMHF pharmacy team are non-voting ex-officio advisory members of the DURB.

R414-60A-3. Responsibilities and Functions.

(1) The DURB shall meet in a public forum, except when meeting in executive session or in petitions subcommittee.

(2) The board shall meet at least four times per year.

(3) The DURB chairperson shall conduct all meetings. The DURB manager shall conduct meetings if the chairperson is not present.

(4) The DURB manager shall schedule meetings, set agendas, provide meeting materials, keep minutes, record DURB business, notify DMHF when vacancies occur, provide meeting notices, and coordinate functions between the DURB and DMHF.

(5) The DURB may consider recommendations, criteria, and standards produced by the Pharmacy and Therapeutics (P&T) Committee.

KEY

Medicaid

Date of Enactment or Last Substantive Amendment

June 27, 2018

Notice of Continuation

June 13, 2017

Authorizing, Implemented, or Interpreted Law

26-18-3; 26-1-5; 26-18 Part 2


Additional Information

Contact

For questions regarding the content or application of rules under Title R414, please contact the promulgating agency (Health, Health Care Financing, Coverage and Reimbursement Policy). A list of agencies with links to their homepages is available at http://www.utah.gov/government/agencylist.html or from http://www.rules.utah.gov/contact/agencycontacts.htm.