Today, the Centers
for Medicare & Medicaid Services (CMS) released the annual FFS Drug
Utilization Review Summary Report, and for the first time released an
annual MCO DUR Summary Report. These reports provide an important snapshot
of individual state Medicaid FFS and MCO program activities, interventions
and innovations to address specific needs, issues and factors that may
affect clinical outcomes for beneficiaries. The annual publication is
highly anticipated by states to see their work highlighted and to learn
from innovative practices of other states.
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 DUR program. States are required to
report on prescribing patterns, generated cost savings, and operations of
their DUR programs including new innovative practices. CMS has collected
States’ Medicaid FFS DUR annual reports since 1995 and published summaries
on Medicaid.gov since
FFY 2010.
Submitted state
surveys are analyzed and compiled into FFS and MCO Medicaid State DUR
Summary Reports which are published on Medicaid.gov in
the fall of each year. A high level comparison of states’ DUR FFS and MCO
survey responses can be found in these national report summaries and
detailed individual state FFS responses, including the national summaries,
can also be found on Medicaid.gov.
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