Medicaid Fee-For-Service (FFS) and Managed Care Organization (MCO) Federal Fiscal Year (FFY) 2019 Annual National and Individual State Drug Utilization Review (DUR) Reports

Today, the Centers for Medicare & Medicaid Services (CMS) released the annual FFS Drug Utilization Review Summary Report, and for the first time released an annual MCO DUR Summary Report. These reports provide an important snapshot of individual state Medicaid FFS and MCO program activities, interventions and innovations to address specific needs, issues and factors that may affect clinical outcomes for beneficiaries.  The annual publication is highly anticipated by states to see their work highlighted and to learn from innovative practices of other states.

Section 1927(g)(3)(D) of the Social Security Act (the Act) requires each state to submit an annual report on the operation of its DUR program. States are required to report on prescribing patterns, generated cost savings, and operations of their DUR programs including new innovative practices. CMS has collected States’ Medicaid FFS DUR annual reports since 1995 and published summaries on Medicaid.gov since FFY 2010. 

Submitted state surveys are analyzed and compiled into FFS and MCO Medicaid State DUR Summary Reports which are published on Medicaid.gov in the fall of each year. A high level comparison of states’ DUR FFS and MCO survey responses can be found in these national report summaries and detailed individual state FFS responses, including the national summaries, can also be found on Medicaid.gov.

• Medicaid Fee-For-Service (FFS) and Managed Care Organization (MCO) Federal Fiscal Year (FFY) 2019 Annual National and Individual State Drug Utilization Review (DUR) Reports