The Omnibus Budget Reconciliation Act of 1990 (OBRA '90) requires state Medicaid programs to conduct
a comprehensive Drug Utilization Review program. This does not include Connecticut Medical
Assistance clients with third party insurance. The RetroDUR program collects and analyzes claims data against
predetermined, DUR Board approved criteria to identify and correct aberrant prescribing practices, client
misuse, and provider fraud. The RetroDUR program also has functionality to identify potential pharmacy
restriction candidates and to specify a pharmacy and/or physician provider to assist in correcting client
abuse or misuse. The DUR Board is required to implement corrective action to modify practices via appropriate
interventions and demonstrate cost savings.
Concurrent with RetroDUR and using the resulting data, the DUR contractor also conducts a pharmacy restriction
program. Through RetroDUR, provider, and the medical audit division’s input the contractor identifies certain
clients who demonstrate the potential to abuse or misuse of prescription drugs. These clients are offered the
opportunity to change their behavior and demonstrate appropriate use of prescription drugs. If the clients
continue inappropriate behavior, they are restricted to the use of a single pharmacy for a one-year period per
Connecticut State law.
Clients and providers with questions should contact Acentra Health concerning the RetroDUR
program operations or pharmacy restriction by calling toll-free to
1-877-719-3123 or by fax to
1-866-743-9788. Further information about the RetroDUR program is available through the following links: