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.
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)