HCFA(now known as CMS) performs drug utilization analysis on an ad hoc basis for the mental health therapeutic classes. The findings of HCFA(now known as CMS)'s reviews are not for public distribution. All Medicaid and State Mental Health Agencies perform some type of drug utilization review, in accordance with the requirements OBRA '90. A survey of Medicaid programs found that 14 States perform DUR in-house, 31 contract the process out, and 4 do a combination of the two.19 A large majority of States (42) perform Prospective DUR (PRODUR) in addition to retrospective DUR.
The DoD performs DUR through a contract staff. For mental health prescriptions, the goal is to minimize duplicated medications and overdosing. The VA has a national in-house DUR database that is reviewed on a regular basis.