The Nebraska Drug Utilization Review (DUR) Board consists of eight pharmacists and five physicians who are active in their respective professions. The DUR Board also includes two pharmacy students representing each school/college of pharmacy in Nebraska, and pharmacist consultants from the Nebraska Medicaid Drug Program.
The goals of the DUR Board are to improve the quality of pharmacy services and to ensure rational, cost-effective medication therapy for Nebraska Medicaid recipients. DUR Board members assess the utilization, quality, medical appropriateness and cost of prescribed medication through the evaluation of claims data. Activities of the DUR Board include:
- Conduct monthly retrospective DUR profile reviews which are either patient specific or therapeutic/problem-focused.
- Provide prescription profile reviews for specific patients when requested by a provider or the Medicaid Department. Specific patient profile reviews are available to all Medicaid providers who have questions about their patient's drug therapy or utilization patterns.
- Review policy issues and provide recommendations on a variety of topics when requested by the Medicaid Department. Areas of review include, but are not limited to, prospective DUR criteria and Prior Authorization criteria. Recommendations made to the Medicaid Department by the DUR Board are not binding upon the State in any way.
- Inform providers of their patients' drug use patterns through provider intervention letters. Provider intervention letters are designed for educational purposes and are meant to assist the provider in the further assessment of the patient's drug therapy requirements.
If you have any questions about the Nebraska DUR Board, contact Nebraska DUR Director, Marcia Mueting, PharmD, RP, at 402-420-1500.