Back to top
This variable is contained in the following files: Plan Characteristics File
SAS Name
OTC_UM_PROGRAM

This variable indicates whether or not the Part D plan pays for Over-the-Counter medications (OTCs) under its Utilization Management (UM) Program.

Comments

Plans that elect to cover OTC drugs as part of general drug utilization management or part of a step therapy protocol have identified the applicable drugs and they appear in the OTC Drug file (which is delivered as part of the Formulary File). When OTC_UM_PROGRAM='Y' then the over-the-counter drugs that appear in the OTC Drug File are allowed by the plan.

Source: CMS (HPMS Files)

CodeCode value
Y
Yes
N
No