Sec. 31. (a) An intervention developed under section 28(a)(4) of this chapter that involves a physician must be approved by at least three (3) of the four (4) physician members of the board before implementation.
(b) An intervention that involves a pharmacist must be approved by at least three (3) of the four (4) pharmacist members of the board before implementation.
(c) Interventions include the following:
(1) Information disseminated to physicians and pharmacists to ensure that physicians and pharmacists are aware of the board's duties and powers.
(2) Written, oral, or electronic reminders of recipient-specific or drug-specific information that are designed to ensure recipient, physician, and pharmacist confidentiality, and suggested changes in the prescribing or dispensing practices designed to improve the quality of care.
(3) Use of 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) The creation of an educational program using data provided through DUR to provide for active and ongoing educational outreach programs to improve 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.
As added by P.L.75-1992, SEC.19. Amended by P.L.3-2008, SEC.96.
Structure Indiana Code
Chapter 35. Drug Utilization Review
12-15-35-1. "Appropriate and Medically Necessary" Defined
12-15-35-3. "Compendia" Defined
12-15-35-4. "Counseling" Defined
12-15-35-4.5. "Covered Outpatient Drug" Defined
12-15-35-5. "Criteria" Defined
12-15-35-6. "Drug-Disease Contraindication" Defined
12-15-35-7. "Drug-Drug Interaction" Defined
12-15-35-8. "Drug Utilization Review" or "Dur" Defined
12-15-35-9. "Intervention" Defined
12-15-35-10. "Overutilization or Underutilization" Defined
12-15-35-11. "Pharmacist" Defined
12-15-35-12. "Physician" Defined
12-15-35-13. "Prospective Dur" Defined
12-15-35-14. "Retrospective Dur" Defined
12-15-35-15. "Standards" Defined
12-15-35-17. "Therapeutic Appropriateness" Defined
12-15-35-17.5. "Therapeutic Classification" or "Therapeutic Category" Defined
12-15-35-18. "Therapeutic Duplication" Defined
12-15-35-18.5. Application of Chapter
12-15-35-18.7. Formulary Requirements
12-15-35-19. Drug Utilization Review Board; Establishment
12-15-35-20. Membership of Board
12-15-35-20.1. Conflicts of Interest
12-15-35-20.5. Therapeutics Committee Established; Members; Limitations; Terms; Votes; Meetings
12-15-35-21. Board; Appointment; Term
12-15-35-22. Qualifications of Board Members
12-15-35-23. Physician Appointments; Geographic Balance
12-15-35-24. Reappointment of Members
12-15-35-25. Chairman; Compensation; Expenses
12-15-35-27. Retrospective and Prospective Dur Program Responsibility
12-15-35-28. Duties of the Board; Preferred Drug List; Report
12-15-35-28.5. Therapeutics Committee Duties
12-15-35-29. Quorum; Majority Vote on Dur Criteria and Standards for Prescribing
12-15-35-30. Local Practices; Monitoring
12-15-35-31. Intervention; Approval; Requisites
12-15-35-32.1. Annual Report Contents
12-15-35-34. Confidential Identifying Information; Release of Cumulative Nonidentifying Information
12-15-35-35. Prior Approval Program for Outpatient Drugs; Standards
12-15-35-36. Advisory Committees
12-15-35-37. Medicaid State Plan; Inclusion of Retrospective and Prospective Dur Program
12-15-35-38. Dur Program Guidelines and Procedures
12-15-35-39. Retrospective Dur Requisites
12-15-35-40. Prospective Dur Requisites
12-15-35-41. Board Activities Under Ic 34-30-15
12-15-35-43. Confidentiality; Pharmacist Data and Information
12-15-35-44. Confidentiality; Violations; Penalty
12-15-35-45. Outpatient Drug Formulary; Requirements
12-15-35-46. Review of Proposed Formulary
12-15-35-47. Review of Changes to Formulary
12-15-35-48. Board Review of Managed Care Organization Prescription Drug Program
12-15-35-49. Information Provided by Office
12-15-35-50. Maximum Allowable Cost Schedule for Drugs; Pharmacy Participation in Medicaid Program