Prescription Drugs and Medicaid: Automated Review Systems Can Help Promote Safety, Save Money
AIMD-96-72
Published: Jun 11, 1996. Publicly Released: Jul 11, 1996.
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Highlights
Pursuant to a congressional request, GAO reviewed states' experiences with automated prospective drug utilization review (PRODUR) systems in their Medicaid programs, focusing on: (1) how these systems can improve patient safety, control program costs, and reduce fraud, waste, and abuse; and (2) impediments to effective implementation of PRODUR systems.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Health and Human Services | Given the substantial safety benefits that can accrue to Medicaid recipients and the strong potential for immediate savings to the Medicaid program through the effective use of automated PRODUR systems, the Secretary of Health and Human Services should direct the Administrator, Health Care Financing Administration, to actively facilitate state sharing of information on the most efficient use of PRODUR systems. One way would be to quickly help establish a working group or other such forum for coordinating the collecting and sharing of information on best practices for automated PRODUR programs, on a nationwide basis. |
HCFA did not actively facilitate sharing information with the states on the most efficient use of PRODUR systems. However, GAO identified in a February 1997 follow-up survey, that the states received copies of the report and that this report was instrumental in many of these states implementing automated PRODUR systems. Moreover, several states told GAO they implemented some or all of the best practices identified in the report.
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Topics
Best practicesDrugsHealth care cost controlHealth care programsMedicaidMedical information systemsPatient care servicesTherapyPrescription drugsPatient care