What is one of the key provisions of OBRA 90 regarding state Medicaid programs?

One of the key provisions of the Omnibus Budget Reconciliation Act of 1990 (OBRA 90) concerning state Medicaid programs is the requirement for mandatory Drug Utilization Review (DUR). This provision was established to ensure that Medicaid recipients receive safe and appropriate medications, enhancing the quality of care while minimizing the risk of drug-related issues.

Mandatory DUR includes two main components: prospective and retrospective reviews. The prospective DUR must be conducted before medications are dispensed, allowing pharmacists to evaluate prescriptions for potential drug interactions, allergies, and other clinically relevant factors. The retrospective review assesses prescribing patterns and medication use after the fact, identifying trends and areas for improvement in medication therapy.

By mandating DUR, OBRA 90 not only aims to improve patient safety but also encourages more responsible prescribing and dispensing practices among healthcare providers. This key provision helps uphold the integrity of healthcare within state Medicaid programs by ensuring that patients receive medications that are appropriate for their clinical circumstances and that the overall healthcare costs are managed effectively.