Chapter 70 Oregon Laws 2003

AN ACT

HB 2558

Relating to Drug Use Review Board; amending ORS 414.360 and 414.370.

Be It Enacted by the People of the State of Oregon:

SECTION 1. ORS 414.360 is amended to read:

414.360. (1) The Drug Use Review Board shall advise the Department of Human Services on:

[(1)] (a) Adoption of rules to implement ORS 414.350 to 414.415 in accordance with the provisions of ORS chapter 183.

[(2)] (b) Implementation of the medical assistance program retrospective and prospective programs as described in ORS 414.350 to 414.415, including the type of software programs to be used by the pharmacist for prospective drug use review and the provisions of the contractual agreement between the state and any entity involved in the retrospective drug use review program.

[(3)] (c) Development of and application of the criteria and standards to be used in retrospective and prospective drug utilization review in a manner that insures that such criteria and standards are based on the compendia, relevant guidelines obtained from professional groups through consensus-driven processes, the experience of practitioners with expertise in drug therapy, data and experience obtained from drug utilization review program operations. The board shall have an open professional consensus process for establishing and revising criteria and standards. Criteria and standards shall be available to the public. In developing recommendations for criteria and standards, the board shall establish an explicit ongoing process for soliciting and considering input from interested parties. The board shall make timely revisions to the criteria and standards based upon this input in addition to revisions based upon scheduled review of the criteria and standards. Further, the drug utilization review standards shall reflect the local practices of prescribers in order to monitor:

[(a)] (A) Therapeutic appropriateness.

[(b)] (B) Overutilization or underutilization.

[(c)] (C) Therapeutic duplication.

[(d)] (D) Drug-disease contraindications.

[(e)] (E) Drug-drug interactions.

[(f)] (F) Incorrect drug dosage or drug treatment duration.

[(g)] (G) Clinical abuse or misuse.

[(h)] (H) Drug allergies.

[(4)] (d) Development, selection and application of and assessment for interventions for medical assistance program prescribers, dispensers and patients that are educational and not punitive in nature.

(2) In reviewing retrospective and prospective drug use, the board may consider only drugs that have received final approval from the federal Food and Drug Administration.

SECTION 2. ORS 414.370 is amended to read:

414.370. In appropriate instances, interventions developed under ORS 414.360 [(4)] (1)(d) may include the following:

(1) Information disseminated to prescribers and pharmacists to insure that they are aware of the duties and powers of the Drug Use Review Board.

(2) Written, oral or electronic reminders of recipient-specific or drug-specific information that are designed to insure recipient, prescriber and pharmacist confidentiality, and suggested changes in the prescribing or dispensing practices designed to improve the quality of care.

(3) Face-to-face discussions between experts in drug therapy and the prescriber or pharmacist who has been targeted for educational intervention.

(4) Intensified reviews or monitoring of selected prescribers or pharmacists.

(5) Educational outreach through the retrospective program focusing on improvement of prescribing and dispensing practices.

(6) The timely evaluation of interventions to determine if the interventions have improved the quality of care.

(7) The review of case profiles before the conducting of an intervention.

Approved by the Governor May 9, 2003

Filed in the office of Secretary of State May 9, 2003

Effective date January 1, 2004

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