Indiana Code 12-15-35-14. “Retrospective DUR” defined
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Terms Used In Indiana Code 12-15-35-14
- criteria: means the predetermined and explicitly accepted elements that are used to measure drug use on an ongoing basis to determine if the use is appropriate, medically necessary, and not likely to result in adverse medical outcomes. See Indiana Code 12-15-35-5
- standards: means the acceptable range of deviation from the criteria that reflects local medical practice and that is tested on the Medicaid recipient database. See Indiana Code 12-15-35-15
Sec. 14. As used in this chapter, “retrospective DUR” means the part of the drug utilization review program that assesses or measures drug use based on an historical review of drug use data against predetermined and explicit criteria and standards that are developed on an ongoing basis with professional input.
As added by P.L.75-1992, SEC.19.