WSR 04-11-009



(Medical Assistance Administration)

[ Filed May 5, 2004, 4:19 p.m. ]

Date of Adoption: April 30, 2004.

Purpose: To change the name of MAA's drug utilization and education (DUE) council in accordance with federal regulations and to include language about the Pharmacy and Therapeutics Committee. This rule is being adopted in coordination with the Health Care Authority's adoption of rules in chapter 182-50 WAC.

Citation of Existing Rules Affected by this Order: Amending WAC 388-530-1850.

Statutory Authority for Adoption: RCW 74.04.050, 74.04.057, and 74.08.090.

Other Authority: SB 6088, section 10, chapter 29, Laws of 2003 1st sp.s.; 42 C.F.R. 456.716; RCW 41.05.160.

Adopted under notice filed as WSR 04-07-137 on March 22, 2004.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 1, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Effective Date of Rule: Thirty-one days after filing.

April 30, 2004

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

AMENDATORY SECTION(Amending WSR 02-17-023, filed 8/9/02, effective 9/9/02)

WAC 388-530-1850   Drug ((utilization and education (DUE) council)) use review (DUR) board.   In accordance with 42 C.F.R. 456.716, the medical assistance administration (MAA) establishes a drug ((utilization and education (DUE) council and determines membership rotation)) use review (DUR) board (also known as the drug utilization & education (DUE) council).

(1) The ((DUE council)) DUR board:

(a) ((Has a minimum of eight and a maximum of ten members, representing)) Includes health professionals who are actively practicing ((health care professionals)) and licensed in the state of Washington and who have recognized knowledge and expertise in one or more of the following:

(i) The clinically appropriate prescribing of covered outpatient drugs;

(ii) The clinically appropriate dispensing and monitoring of covered outpatient drugs;

(iii) Drug use review, evaluation, and intervention; and

(iv) Medical quality assurance((; and

(v) Disease state management)).

(b) Is made up of at least one-third but not more than fifty-one percent physicians, and at least one-third ((but not more than fifty-one percent)) pharmacists((; and

(c) Includes an advanced registered nurse practitioner and a physician assistant.

(2) The DUE council)).

(2) MAA may appoint members of the pharmacy and therapeutics committee established by the health care authority (HCA) under chapter 182-50 WAC or other qualified individuals to serve as members of the DUR board.

(3) The DUR board meets periodically to:

(a) Advise MAA on drug utilization review activities;

(b) Review provider and patient profiles;

(c) Recommend adoption of standards and treatment guidelines for drug therapy;

(d) ((Provide)) Recommend interventions targeted toward correcting drug therapy problems; and

(e) Produce an annual report.

(4) MAA has the authority to accept or reject the recommendations of the DUR board in accordance with 42 C.F.R. 456.716(c).

[Statutory Authority: RCW 74.09.080, 74.04.050 and 42 C.F.R. Subpart K, subsection 162.1102. 02-17-023, 388-530-1850, filed 8/9/02, effective 9/9/02. Statutory Authority: RCW 74.08.090, 74.04.050. 01-01-028, 388-530-1850, filed 12/7/00, effective 1/7/01. Statutory Authority: RCW 74.08.090. 96-21-031, 388-530-1850, filed 10/9/96, effective 11/9/96.]

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