The Omnibus Budget Reconciliation Act of 1990 (OBRA 90) mandates that state Medicaid programs perform retrospective and prospective drug utilization reviews to evaluate prescribed medications and ensure appropriate usage. It also requires state pharmacy boards to develop educational programs for pharmacists on drug utilization review. Additionally, OBRA 90 states that pharmacists must offer counseling to Medicaid patients and document any counseling provided.

1. OBRA 90
•omnibus budget reconciliation act of 1990
•mandates each state Medicaid program to
perform retrospective reviews on rx drug use
•retrospective drug utilization review---should we
have paid for that drug or use another?
•prospective drug utilization review---should
Medicaid pay for xyz drug? pharmacist must give
input. Look at duplicate medication, drug
interaction, contraindications, incorrect dosage,
allergies, drug abuse?

2. OBRA 90
• State pharm board must develop education programs
to keep pharmacists current with DUR.
• OBRA says pharmacist must offer personal
counseling to each Medicaid patient.
• state law may say everybody gets offered counseling
• if patient is interested then pharmacist must provide it.
• must keep record of counsel info
• requires state Medicaid provider pharmacists to review
Medicaid recipients drugs entire drug profile before
filling their prescription