MEDICAID DUR PROGRAMS COULD REQUIRE "REMEDIAL" ACTIONS FROM PROVIDERS AS "MID-RANGE" RESPONSE; PRIVACY, SOFTWARE DESIGN ARE CHALLENGES -- HHS IG REPORT
Executive Summary
State Medicaid drug utilization review programs should consider using "mid-range" interventions in response to provider practices that require more than an informational letter and less than punitive action, the HHS Inspector General suggests in a May report on the current status of state DUR programs.