2018 Vermont Statutes
Title 3 Appendix - Executive Orders
Chapter 33 - Human Services
App 33-20 (No. 08-10) [Drug Utilization Review Board

Executive Order No. 33-20

(No. 08-10)

[Drug Utilization Review Board]

WHEREAS, the State of Vermont participates in the Medicaid program; and

WHEREAS, the Omnibus Budget Reconciliation Act of 1990 (the Act), codified at 42 U.S.C. § 1396r-8(g), requires the establishment of a drug use review program for states that participate in Medicaid; and

WHEREAS, the drug use review program must assure that outpatient drug claims for prescription drugs are appropriate, medically necessary and are not likely to result in adverse medical results; and

WHEREAS, the Act requires a Drug Use Review Board be established to carry out the requirements of the program under the sponsorship of the state Medicaid agency.

NOW, THERE, I, James H. Douglas, by virtue of the power vested in me as Governor of the State of Vermont, do hereby establish a Drug Utilization Review Board with membership as follows:

at least one-third, but not more than half, of the Board's membership shall be licensed and actively practicing physicians appointed by the Commissioner of the Department of Health Access with the approval of the Governor; and

at least one-third of the membership shall be licensed and actively practicing pharmacists appointed by the Commissioner of the Department of Health Access with the approval of the Governor; and

may include other members as proposed by the Commissioner and approved by the Governor.

Board members shall be appointed to staggered two-year terms and shall not serve more than two consecutive full terms. The chair shall be elected by vote of the members.

The Board shall carry out the duties and responsibilities required by federal and state law and shall participate in the efforts of the Department of Vermont Health Access to assure that prescriptions for Medicaid patients are appropriate, medically necessary and not likely to result in adverse medical results. Specifically, the Board shall:

(a) approve any standards utilized in both prospective and retrospective drug utilization review;

(b) evaluate the results of the application of standards to Medicaid claims data to identify utilization patterns which suggest drug therapy problems;

(c) determine the content and methodology of specific activities to educate practitioners on common therapy problems;

(d) provide ongoing educational interventions for practitioners targeted through retrospective review;

(e) report annually to the Commissioner of the Department of Vermont Health Access concerning the nature and scope of retrospective drug utilization review and educational activity.

Members of the Board shall be entitled to compensation in accordance with 32 V.S.A. § 1010 subject to the availability of funding. The Board shall be attached to the Department of Vermont Health Access for administrative support.

This Executive Order supersedes and replaces Executive Order No. 03-93 (codified as Executive Order No. 18-7). The Drug Utilization Review Board created by this Executive Order shall be a continuation and successor to the Board established by Executive Order No. 03-93. Members of the Board on the effective date of this order shall be reappointed by the Commissioner to serve staggered one and two year terms ending on August 31, 2011 or August 31, 2012. Any current member having served the equivalent of two consecutive full terms on the date their term expires shall not be eligible for re-appointment for a period of two years.

This Executive Order shall take effect upon signing.

Dated September 8, 2010.