Print this pageTo meet federal Centers for Medicare and Medicaid Services (CMS) requirements applying to Health & Recovery Services Administration (HRSA) programs, the state P&T Committee will also be fulfilling the role of a Drug Utilization Review Board.
To comply with federal and state requirements, the following membership criteria were developed:
The committee must consist of at least 31% but no more than 51% pharmacists and physicians.
Members must be actively practicing in their area of clinical expertise and must have knowledge and expertise in one of the following:
- Clinically appropriate prescribing of covered outpatient drugs
- Clinically appropriate dispensing and monitoring of covered outpatient drugs
- Drug use review
- Medical quality assurance
- Disease state management
Members cannot currently or within the previous 18 months be employed by:
- A pharmaceutical manufacturer
- A pharmacy benefits management company
- Any agency administering state purchased health care programs
The members main practice focus is outpatient care. Specialties represented on the committee include:
- Family practice
- Internal medicine
- Behavioral health
Members must have experience in:
- Evidence-based medicine
- Serving on a pharmacy and therapeutics committee
Committee membership is representative of programs' geographic distribution.
Members who are active in professional societies are preferred.
Member cannot have had any state licensure actions or Medicaid/Medicare sanctions.
