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The Journal of Managed Care & Specialty Pharmacy is a monthly peer-reviewed medical journal covering all aspects of managed care pharmacy. It was established in 1995 and is published by the Academy of Managed Care Pharmacy. The editor-in-chief is Laura E. Happe. According to the Journal Citation Reports, the journal has a 2021 impact factor of ...
Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its medical appropriateness before it is provided, by using evidence-based criteria or guidelines.
AMCP (Academy of Managed Care Pharmacy) is a professional organization representing the interests of pharmacists who practice in managed care settings. [2] [3] [4] It publishes the Journal of Managed Care & Specialty Pharmacy. [5] AMCP is a member organization of the Alliance for a Stronger FDA. [6]
In community pharmacy Settings, Federal Law (OBRA-90) requires drug utilization review for patients receiving medication through Medicaid. [8] Then Drug utilization review was common in society. Recognizing that Medicaid recipients faced similar risks in the 1980s, Congress provided for the ambulatory drug utilization review under the Omnibus ...
Clinical peer review, also known as medical peer review is the process by which health care professionals, including those in nursing and pharmacy, evaluate each other's clinical performance. [ 1 ] [ 2 ] A discipline-specific process may be referenced accordingly (e.g., physician peer review , nursing peer review ).
The Knox-Keene Health Care Service Plan Act of 1975 is a set of Californian laws that regulate Healthcare Service Plans. Under these laws, pharmacy benefit managers with contracts to Health care service plans are required by law to be registered with the Department of Managed Health Care to disclose information. [58] SB 966: Pharmacy benefits
Step therapy, also called step protocol or a fail first requirement, is a managed care approach to prescription.It is a type of prior authorization requirement that is intended increase insurance company profits at the expense of patient health by forcing patients onto lower cost prescription drugs.
The American Journal of Managed Care is a monthly peer-reviewed medical journal published by Managed Care & Healthcare Communications. [1] The editors-in-chief are A. Mark Fendrick and Michael E. Chernew. [2] In 2022 it had an impact factor of 3.2. [3]