South Carolina Multistate Pharmacy Jurisprudence Examination (MPJE) Practice Exam

What does the Omnibus Reconciliation Act of 1990 require for drug utilization review?

1. Only retrospective review for all patients

2. Both prospective and retrospective review

3. Only prospective review for Medicaid patients

4. No specific review requirements

The correct answer is: Both prospective and retrospective review

The Omnibus Reconciliation Act of 1990 (OBRA '90) established important requirements for drug utilization review (DUR) in the context of Medicaid programs. Specifically, the act mandates that states implement both prospective and retrospective reviews for Medicaid recipients. Prospective review involves evaluating a patient's medication regimen before the medication is dispensed, ensuring that medications are appropriate, effective, and safe for the patient. This process helps identify potential issues such as drug interactions, allergies, and duplications in therapy prior to medication being given. Retrospective review, on the other hand, is an evaluation that occurs after a medication has been dispensed. It assesses the outcomes of the medication therapy and helps in identifying patterns that may require modifications in practice or policy. The dual approach of both prospective and retrospective reviews ensures a comprehensive evaluation of drug therapy for patients, ultimately improving medication safety and therapeutic outcomes. This requirement reflects the federal intent behind OBRA '90 to promote patient-centered care and optimize drug therapy specifically within Medicaid programs. Thus, the requirement of both types of review is essential for meeting regulatory standards while also promoting high-quality healthcare for Medicaid patients.