OMDR 2627-0001 DUR Committee RFLI

The Ohio Department of Medicaid (ODM) has issued a Request for Letters of Interest (RFLI) to identify two qualified licensed pharmacists to serve on its Drug Utilization Review (DUR) Committee, which plays a crucial role in promoting appropriate and safe medication use among Medicaid recipients. The selected pharmacists will provide clinical expertise by reviewing pharmacy claims, assessing drug therapy appropriateness, and recommending interventions aimed at reducing fraud, abuse, and overuse of prescribed medications. The contract, anticipated to commence in October 2025 and extend through June 2027 with potential renewal options up to 2033, offers compensation of $150 per meeting, with up to 12 meetings scheduled annually. Submissions must be made electronically via OhioBuys by October 15, 2025, and will be evaluated based on a detailed scoring system that considers qualifications, experience, and ability to perform clinical reviews, with a minimum passing score of 60 out of 100 points. The selection process emphasizes strict adherence to submission requirements, including valid Ohio pharmacy licensure, relevant experience, and the capacity to attend regular meetings. The contract stipulates comprehensive confidentiality and data protection measures, aligning with federal and state laws such as HIPAA, and grants ODM ownership of all deliverables and data produced. The DUR Committee operates under established by-laws that govern its procedures, membership, and conflict of interest disclosures, ensuring transparency and compliance with regulatory standards. The overall process underscores ODM’s commitment to leveraging clinical expertise to enhance medication safety, optimize drug therapy, and uphold integrity within the Medicaid pharmacy program.