{"data":{"id":"us-ky/krs-205.5638","jurisdiction":"us-ky","citation":"KRS 205.5638","heading":"Duties and responsibilities of board.","body":"(1) The Drug Management Review Advisory Board shall have at least the following\nduties and responsibilities:\n(a) Review and make recommendations to the commissioner or designee on\npredetermined prospective drug use review standards submitted to the board\nby the Department for Medicaid Services or its contractor;\n(b) Evaluate the use of the predetermined prospective drug use review standards\nand make recommendations to the commissioner or the commissioner's\ndesignee concerning modification or elimination of exis ting standards and the\nneed for additional standards;\n(c) Make recommendations to the commissioner or the commissioner's designee\nconcerning guidelines governing written predetermined standards that\npharmacies must use in conducting prospective drug use re view if they do not\nuse approved software;\n(d) Oversee the retrospective drug use review contract and incorporate the results\ninto predetermined retrospective drug use review standards;\n(e) Review and make recommendations to the commissioner or the\ncommissioner's designee on predetermined retrospective drug use standards\nsubmitted to the board by the Department for Medicaid Services;\n(f) Make recommendations to the commissioner or the commissioner's designee\nconcerning the modification or elimination of exi sting predetermined\nretrospective drug use review standards and the need for additional standards;\n(g) Identify and develop educational topics on common drug therapy problems if\nneeded to improve prescribing or dispensing practices of practitioners;\n(h) Make recommendations to the commissioner or the commissioner's designee\nconcerning which mix of interventions would most effectively lead to an\nimprovement in the quality of drug therapy;\n(i) Conduct periodic reevaluations to determine the effectiveness of e ducational\neffort and, if necessary, modify the interventions;\n(j) Recommend standards for the identification of suspected fraud and abuse;\n(k) Prepare and submit to the commissioner an annual drug use review report that\ncontains the following information:\n1. A description of the nature and scope of the retrospective drug\nutilization program including the identity of the contractor, the\nfrequency of screening of claims data and the criteria and standards\nused, along with new or revised copies of the clinica l criteria, and in\nsubsequent years, a list of revised criteria and deleted criteria;\n2. A summary of nonpatient and provider specific educational activities\nincluding information on the use of each type of patient and provider\nspecific intervention that indicates the guidelines for use and frequency\nof use by type of intervention and the effe ctiveness of each type of\nintervention on changes in prescribing or dispensing practices;\n3. An evaluation of the adequacy of prospective drug use review database\nsoftware; and\n4. Details on policy guidelines adopted by the board pertaining to written\ncriteria that pharmacies may use if they do not use a computer\nprospective drug utilization review database; and\n(l) In advising the department, the board may consider the effectiveness of all\ninterventions used to manage a particular disease over time, the st age and\nintensity of the disease, and the economic, clinical, and patient -prospective\noutcomes, including quality of life.\n(2) The board shall function in accordance with the Kentucky Open Meetings Law and\nthe Kentucky Open Records Act. The board may desig nate subcommittees to\naddress specific issues and to report findings to the board. In conducting its\nbusiness, the board shall utilize distance communication technologies whenever\npossible.\n(3) Clerical and administrative support shall be provided the boar d through the Cabinet\nfor Health and Family Services or by contract.","path":["KRS Chapter 205"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=7722","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:52:03Z","sha256":"58236b18a18e3c4ab49e5c2b495a81df31badf48e7bf86c40df86c63c30638f8","source_id":"us-ky","stale":false,"prev":"us-ky/krs-205.5636","next":"us-ky/krs-205.5639"},"notice":"GroundRules: Original legal text. Not legal advice."}