Section 10-12 - Pharmacy and Therapeutics (P&T) Committee (a) Pharmacy Services shall have a P&T Committee to meet the DUR requirements designated in Section 7 of this Chapter. The P&T Committee shall be made up as follows: - (i) At least one third (1/3), but not more than fifty-one percent (51%) physicians;
- (ii) At least one third (1/3), but not more than fifty-one (51%) pharmacists; and
- (iii) At least one physician's assistant or nurse practitioner.
(b) The responsibilities of the P&T Committee include: - (i) Prospective Drug Utilization Review, including determination of prior authorization criteria in accordance with Section 13 of this Chapter;
- (ii) Retrospective Drug Utilization Review including periodic review of client profiles and claims data in order to identify patterns of fraud, abuse, gross overuse, or inappropriate or medically unnecessary care among physicians, pharmacists, or clients, or associated with specific drugs or groups of drugs;
- (iii) Provider education programs to include written or live dissemination of information in group or individual settings;
- (iv) Review of literature and providing recommendations to Medicaid Pharmacy Services for the purpose of creating the Preferred Drug List in accordance with Section 15 of this chapter;
- (v) Providing recommendations and feedback to Medicaid Pharmacy Services regarding pharmacy policy in general; and
- (vi) Other duties as requested by the Department.
048-10 Wyo. Code R. § 10-12