The Nebraska Drug Utilization Review (DUR) Board consists of eight pharmacists and five physicians who are active in their respective professions. The DUR Board also includes two pharmacy students representing each school/college of pharmacy in Nebraska, and pharmacist consultants from the Nebraska Medicaid Drug Program.
The goals of the DUR Board are to improve the quality of pharmacy services and to ensure rational, cost-effective medication therapy for Nebraska Medicaid recipients. DUR Board members assess the utilization, quality, medical appropriateness and cost of prescribed medication through the evaluation of claims data. Activities of the DUR Board include:
If you have any questions about the Nebraska DUR Board, contact the Nebraska DUR program at DHHS.MedicaidPharmacyUnit@Nebraska.gov.
Recommendations for review topics and comments and suggestions about the Nebraska Medicaid DUR program can be directed to DHHS.MedicaidPharmacyUnit@Nebraska.gov.
Meeting agendas are posted to the website 30 days prior to the scheduled meeting. From the date that the agenda is posted until after the DUR Board meeting is held, it is inappropriate for anyone receiving compensation from a pharmaceutical manufacturer, to contact a Board member regarding DUR Board agenda items. If a Board Member is contacted by anyone receiving compensation from a pharmaceutical manufacturer, no public comment will be allowed on that manufacturer's agenda item during that DUR Board meeting. If a DUR Board Member is contacted about an agenda item, it shall be reported to the DUR Director.
DUR Board meetings are open to the public for attendance. Guidelines for public comment at DUR Board meetings include:
Unsolicited presentations are limited to 5 minutes per drug or topic, regardless of the number of presenters and time will be evenly divided among presenters.
Written materials may be distributed to DUR Board members if 20 copies are supplied to the Director 15 days pr ior to the scheduled meeting.
Next Meeting: January 12, 2021
The 2005 Nebraska Medicaid Reform Plan required Medicaid to place new drugs on Prior Authorization pending review. Drugs that are included in the Preferred Drug List are reviewed by the P & T Committee, all others are reviewed by the Nebraska DUR Board. The New Drug Review process was instituted to examine new drugs and formulations. These drugs generally fall into one of the following categories:
New drug products require Prior Authorization for 6 months. The 6 month Prior Authorization period begins on the date on which a valid claim for a bona fide prescription could be paid for by Medicaid through the Ne-POP system. During the 6 month-review period, prescribers may submit a Medical Necessity form to Medicaid for a patient to obtain the medication. Verification of previous therapies are documented utilizing Medicaid paid claims data. Nebraska Medicaid may request chart documentation to verify the information. A representative of the manufacturer is required to contact the Nebraska DUR Director and request a review to remove the New Drug Prior Authorization. Twenty copies of the Prescribing Information shall be provided to the DUR Director. If any additional drug information is required, it will be requested.