Patient review & restriction programs : lessons learned from state Medicaid programs : CDC Expert Panel Meeting report, Atlanta, GA, August 27– 28, 2012
Corporate Authors:National Center for Injury Prevention and Control (U.S.). Division of Unintentional Injury Prevention.
Description:On August 27 and 28, 2012, the Centers for Disease Control and Prevention (CDC) convened the Medicaid Patient Review and Restriction (PRR) Expert Panel Meeting. Attendees represented state Medicaid agencies, managed care organizations, private insurers, and Federal agencies (see Appendix C for a list of panel members). The goal of the meeting, and this report, was to examine current practices of PRR programs, also called Medicaid “Lock-In” programs, and share insights about the operation of such programs to prevent prescription drug abuse, diversion, and overdose. Ultimately, the meeting sought to use the experiences of the people who run PRR programs to understand what these programs do and how they can do it better. The primary audience for this report is state Medicaid agencies and private insurers.
The suggestions in this report are based on promising practices or interventions and expert opinion. Additional research and evaluation is needed to understand the impact of these practices and interventions on reducing prescription drug abuse and diversion, as well as prescription drug overdoses, both fatal and nonfatal.
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