Available Until 12/31/2023

2022 Medicaid Managed Care Organization (MCO) Drug Utilization Review (DUR) Program Update

Course Description:


Federal law and regulations require that each state Medicaid program conduct a multi-faceted Drug Utilization Review (DUR) program for its fee-for-service (FFS) and Medicaid managed care organization (MCO) beneficiaries to assure that medications prescribed are appropriate, medically necessary, and not likely to result in adverse events. Since 2018, each Medicaid MCO must annually submit a summary of its various DUR activities to the states. The Centers for Medicare and Medicaid Services (CMS) collects and compiles the data submitted to the states and publishes various reports to help states and MCOs refine their DUR programs with the goal of improving drug outcomes in beneficiaries. This presentation will help managed care organizations learn more about this mandatory annual DUR survey, understand recent trends in DUR activities, and suggest activities to improve the programs going forward.


Learning Objectives:


At the completion of this knowledge-based activity, participants will be able to:

  1.        Summarize trends and important topics in DUR programs in state Medicaid MCOs.
  2.        Identify strategies that will improve DUR programs in Medicaid MCOs.
  3.        Describe the changes in the upcoming FFY 2022 state Medicaid MCO DUR survey


John M. Coster, BS, MPS, PhD

Director, Division of Pharmacy CMS


Paul L. Jeffrey, PharmD

Consultant / Senior Director of Pharmacy MassHealth (retired)

Associate Professor, Family Medicine and Community Health / UMass Chan Medical School

Schedule of Educational Activity:

This activity consists of an audio recording, pre-test assessment questions (not required to pass or continue), post-test questions (required to pass with a score of 70% or higher), and a specific activity evaluation.


The Academy of Managed Care Pharmacy (AMCP) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

ACPE UAN: 0233-0000-22-022-H01-P  • Activity Type: Knowledge-Based
Contact Hours: 1.0
Release Date: May 3, 2022 •  Expiration Date: December 31, 2023
Activity Fee: Free for Members and Non-Members

Participants should claim continuing pharmacy education (CPE) credit for this home study activity only if they have not claimed credit for the live activity presented upon release. CPE credit will be processed and reported directly to CPE Monitor. Please allow 72 hours for processing and posting in your NABP account.

To receive credit for an online activity you must:

  • Review the full content of the activity.
  • Successfully complete the post-test (required to pass with a score of 70% or higher, it may be taken a maximum of three times).
  • Complete a specific activity evaluation.

System Technical Requirements/Viewing Requirements:

System Requirements Courses and learning activities are delivered via your Web browser and Acrobat PDF. For all activities, you should have a basic comfort level using a computer and navigating websites. View the minimum technical and system requirements for continuing education online learning activities.


Credit Information

Activity Number Credit Amount Accreditation Period
ACPE UAN #0233-0000-22-022-H01-P 1 Contact Hour May 03, 2022 - December 31, 2023