Which of the following are examples of drug utilization management rules?

Study for the United Health Coverage (UHC) Medicare Basics Test. Prepare with flashcards and multiple-choice questions. Watch for hints and explanations. Ace your exam and expand your healthcare knowledge!

Drug utilization management rules are designed to ensure that medications prescribed to patients are used safely and effectively while also managing costs for patients and insurers. The correct answer highlights specific strategies that health plans employ to monitor and manage the use of medications.

Quantity limits refer to setting a maximum number of units (such as pills or doses) that can be dispensed over a specific time frame. This helps to prevent overuse of medications. Prior authorization requires healthcare providers to obtain approval from the insurer before prescribing certain drugs, ensuring that the prescribed drug is necessary and appropriate for the patient's condition. Step therapy involves starting treatment with the most cost-effective drug before progressing to more expensive options if necessary. Together, these strategies help to promote appropriate medication use and manage healthcare costs effectively, making option B a comprehensive representation of drug utilization management rules.

The other choices do include important concepts related to healthcare and medications but do not specifically consist of utilization management rules. For instance, while an open formulary offers a wider selection of medications, it does not necessarily involve the oversight processes characterized by management rules.

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