{
  "schema": "upg.factor.v1",
  "exam": [
    "PTCE"
  ],
  "domain": "Federal Requirements",
  "confidence": 0.96,
  "updated_at": "2026-09-07",
  "token_cost_hint": 220,
  "integrity": "practice_only",
  "id": "ptce/federal/obra-counseling",
  "title": "OBRA \u201990 \u2014 offer to counsel (Medicaid DUR)",
  "claim": "Federal Medicaid drug-use review rules require states to set pharmacist counseling standards that include at least an offer to discuss the medication with each Medicaid beneficiary (or caregiver), in person when practicable or via a toll-free telephone service.",
  "plain": "Federal floor is the offer to counsel for Medicaid beneficiaries; many boards extend counseling rules to all patients. State board is what you practice under.",
  "citations": [
    {
      "authority": "42 U.S.C. \u00a7 1396r-8(g)",
      "url": "https://www.law.cornell.edu/uscode/text/42/1396r-8",
      "pin": "1396r-8(g) counseling standards",
      "retrieved_at": "2026-09-07",
      "quote": "The pharmacist must offer to discuss with each individual receiving benefits under this subchapter or caregiver of such individual (in person, whenever practicable, or through access to a telephone service which is toll-free"
    }
  ],
  "html": "/factors/ptce/federal/obra-counseling",
  "json": "/factors/ptce/federal/obra-counseling.json"
}