1. OBRA 90 omnibus budget reconciliation act of 1990
mandates each state Medicaid program to perform retrospective reviews on rx drug use
retrospective drug utilization review---should we have paid for that drug or use another?
prospective drug utilization review---should Medicaid pay for xyz drug? pharmacist must give input. Look at duplicate medication, drug interaction, contraindications, incorrect dosage, allergies, drug abuse?

2. OBRA 90
State pharm board must develop education programs to keep pharmacists current with DUR.
OBRA says pharmacist must offer personal counseling to each Medicaid patient.
state law may say everybody gets offered counseling
if patient is interested then pharmacist must provide it.
must keep record of counsel info
requires state Medicaid provider pharmacists to review Medicaid recipients drugs entire drug profile before filling their prescription