Minutes
Drug Utilization Review Board Meeting
DATE:  June 8, 2011		

Meeting Purpose: Quarterly Open Board Meeting 
Meeting opened at 6:04 P.M. by Chair, Sarah McGee 

Agenda Items:
I.   Welcome and Introductory Remarks
II.  Special Population Program Update
III. DUR Annual Clinical Update
IV. MassHealth Drug List Update
V.  DUR Operational Update

Agenda Item	
                                              Discussion	
Conclusions/Follow Up	

Welcome and introductory remarks:
	
Chair, Sarah McGee welcomed board members and guests. It was announced the March minutes were approved at the May 11th meeting.	
Follow Up	

Agenda Item	
                                              Discussion	
Conclusions/Follow Up	

Special Populations Program Update

A brief overview of Community Case Management was presented.  Program data, Special Populations Program growth, and case studies were discussed.	
Informational	

Action 

	
Over the past year there has been increased communication between the CCM pharmacist and the DUR consultants to enhance the following processes: 
•	Assist with CCM member PA requests
•	Guideline development and updates 

CCM will be expanding to include an adult population. This will occur in July 2011 and will encompass approximately 100 new members. 

The CCM pharmacist has also received an increased amount of Department of Children and Families (DCF) consults.

There is expansion of consult requests for  Foster Care Evaluation Services (FaCES Clinic) 

Other activities include participation in the following initiatives:
•	Prescriber Outreach Programs
•	Acquired Brain Injury(ABI) Waiver Program
	
Conclusions:
This program represents an effective strategy to enhance the quality of care for members as a direct result of collaborative efforts between MH and CWM.

Agenda Item	
                                              Discussion	
Conclusions/Follow Up	

DUR Annual Clinical Update 

	
An overview of DUR clinical accomplishments and projects for fiscal year July 10 – June 11 was given. New drug reviews, new clinical guidelines and updates, quality assurance analyses, therapeutic class reviews and initiatives were highlighted.	
Informational	

Action

•	46 new drug reviews 
•	53 therapeutic tables online
•	51 guidelines are online
•	23 Disease/Medication PA forms online 
•	51 Quality Assurance Analyses 
•	3 therapeutic class reviews 
•	Initiatives: ADHD Provider Education Program, Antipsychotics, High Dose /Duplicate therapy Opioid, Provider Outreach Programs (i.e. Palivizumab, Hepatitis C)
•	508 Clinical Review  cases
	
Conclusion: 
It has been a productive and extremely busy year. Annual updates will continue. 

	

Agenda Item	
                                              Discussion	
Conclusions/Follow Up	

MassHealth Drug List Update
	
Provide an update to the drug list additions effective July 11, 2011, and the drug list changes effective July 25, 2011.   
	
Informational	

Action

	
There are 12 new additions effective July 11, 2011. Changes in Prior Authorization status effective July 25, 2011, were also reviewed.

Other updates included :
•	24 therapeutic class tables 
•	6 PA forms 

Two initiatives updated and/or created:
•	Pain Initiative
•	ADHD Initiative 
	
Conclusion: 
Changes in the MassHealth Drug List will continue to be provided as needed.	

Agenda Item	
                                              Discussion	
Conclusions/Follow Up	

MassHealth Drug Utilization Review Operational Overview	
Overview of Operational trends from July 2010 –June 2011 	
Informational	

Action
	
•	Average of 8,000 calls received per month 
•	Average of 7,000 PA requests received per month 
•	The number of appeals in 2010 peaked in September with 21.  
•	Average of 500 provider outreach calls per month 
	
Conclusion: 
Operational updates will continue to be provided as needed.	

Meeting adjourned at 8:00 P.M.

Respectfully submitted by: Vincent Palumbo, Director of DUR

Date: _________________