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.

Terms Used In Indiana Code 12-15-35-31

  • board: refers to the drug utilization review board created under this chapter. See Indiana Code 12-15-35-2
  • DUR: means the program designed to measure and assess on a retrospective and a prospective basis the proper use of outpatient drugs in the Medicaid program. See Indiana Code 12-15-35-8
  • intervention: means an action taken by the board with a prescriber or pharmacist to inform about or to influence prescribing or dispensing practices or utilization of drugs. See Indiana Code 12-15-35-9
  • pharmacist: means an individual who is licensed as a pharmacist in Indiana under IC 25-26. See Indiana Code 12-15-35-11
  • physician: means an individual who is licensed to practice medicine in Indiana under Indiana Code 12-15-35-12
     (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.