{"data":{"id":"us-ok/okla.-stat.-tit.-63-63-5030.2","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 63, § 63-5030.2","heading":"Definitions","body":"As used in Sections 1 through 5 of this act:\n\n1. “Compendia” means the “American Hospital Formulary Services\n\nDrug Information”, “U.S. Pharmacopoeia Drug Information”, peer-\n\nreviewed medical literature, other information provided by\n\nindividuals involved in health care, and information as needed by\n\nthe Medicaid Drug Utilization Review Board;\n\n2. “Criteria” means those explicit and predetermined elements\n\nthat are used to assess or measure drug use on an ongoing basis to\n\ndetermine if the use is appropriate, medically necessary, and not\n\nlikely to result in adverse medical outcomes;\n\n3. “Authority” means the Oklahoma Health Care Authority;\n\n4. “Drug-disease contraindication” means the possibility that\n\nthe therapeutic effect of a drug would be adversely altered by the\n\npresence of another disease or condition;\n\n5. “Drug interactions” means the possibility that two or more\n\ndrugs taken by a patient may lead to clinically significant toxicity\n\nthat is uncharacteristic of any one of the drugs present or that the\n\ntaking of which leads to interference with the effectiveness of one\n\nor any of the drugs;\n\n6. “Drug to drug interaction” means a clinically significant\n\nadverse medical effect that results from the use of two or more\n\ndrugs together;\n\n7. “Drug Utilization Review” or “DUR” means both retrospective\n\nand prospective drug utilization review designed to educate\n\nphysicians and pharmacists and thereby ensure that prescriptions are\n\nappropriate, medically necessary and not likely to have adverse\n\nmedical results;\n\n8. “Overutilization” or “underutilization” means the use of a\n\ndrug in such quantities that the desired therapeutic goal is not\n\nachieved;\n\n9. “Prospective drug utilization review” means the part of a\n\ndrug utilization review program that occurs before a drug is\n\ndispensed, and that is designed to screen, based on explicit and\n\npredetermined criteria and standards, for potential drug therapy\n\nproblems, including, but not limited to:\n\na. therapeutic duplication,\n\nb. drug-disease contraindications,\n\nc. incorrect drug dosage or duration of drug treatment,\n\nd. drug allergy interactions, and\n\ne. clinical abuse or misuse; and\n\n10. “Retrospective drug utilization review” means the part of\n\nthe drug utilization review program that assesses or measures drug\n\nuse based on an historical review of drug use data against\n\npredetermined and explicit criteria and standards on an ongoing\n\nbasis with professional input. Retrospective drug utilization\n\nreview includes the periodic examination of Medicaid drug pharmacy\n\nclaims data and other information sources to identify the frequency\n\nof patterns of fraud, abuse, gross overuse, or inappropriate or\n\nmedically unnecessary care:\n\na. among physicians, pharmacists, and patients, or\n\nb. associated with specific drugs.","path":["OK Code","Title 63"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os63.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"17708509b3327415c5516689ed88de9cec74ded5b1e8be12b3a696bf7da998ea","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-63-63-5030.1","next":"us-ok/okla.-stat.-tit.-63-63-5030.3"},"notice":"GroundRules: Original legal text. Not legal advice."}