The retrospective drug use review program must:
(1) Be based on the guidelines established by the Department of Human Services in consultation with the Drug Use Review Board; and
(2) Use the mechanized drug claims processing and information retrieval system to analyze claims data on drug use against explicit predetermined standards that are based on the compendia and other sources to monitor the following:
(a) Therapeutic appropriateness.
(b) Overutilization or underutilization.
(c) Fraud and abuse.
(d) Therapeutic duplication.
(e) Drug-disease contraindications.
(f) Drug-drug interactions.
(g) Incorrect drug dosage or duration of drug treatment.
(h) Clinical abuse and misuse. [1993 c.578 §12]
Note: See note under 414.350.Section: Previous 414.348 414.350 414.355 414.360 414.365 414.370 414.375 414.380 414.385 414.390 414.395 414.400 414.410 414.415 414.420 Next
Last modified: August 7, 2008