Skip to main content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

States' Actions Based on Medicaid Drug Utilization Reviews

States are required to establish drug utilization review (DUR) programs to receive the Federal share of Medicaid payments (42 CFR §456.703). DUR programs must involve ongoing and periodic retrospective examination of claims data to identify patterns of fraud, abuse, gross overuse, or medically unnecessary care. (42 CFR §456.709). We will review the actions that States have taken on the basis of information generated by their DUR programs related to inappropriate dispensing and potential abuse of prescription drugs, including opiates.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
Removed Centers for Medicare & Medicaid Services States' Actions Based on Medicaid Drug Utilization Reviews Office of Evaluation and Inspections OEI-05-13-00550 Not Applicable