OBJECTIVES: In March 2015, the Office of the Inspector General (OIG) issued a report concerning the use of antipsychotics. The OIG highlighted several quality measurement areas including indications for use, appropriate dosage and duration of use, monitoring, polypharmacy, side-effects and age appropriate use. The purpose of this project was identifying quality measures concerning these seven areas and testing measure performance in the eligible Mississippi Medicaid population. METHODS: A retrospective analysis during the 2014 calendar year was conducted using Mississippi Medicaid administrative claims and beneficiary eligibility data. Individuals below the age of 21 years with at least one month of eligibility in Medicaid during the study period and antipsychotic prescription claims were included. Quality measures calculated included metabolic screening for new and existing antipsychotic prescriptions, availability of a supporting diagnosis, and antipsychotic polypharmacy. Measure specifications proposed by the National Collaborative for Innovation in Quality Measurement and developed by HEDIS were used to address OIG identified areas identified. RESULTS: A total of 19,009 beneficiaries (51% female, 49% male, 54% African Americans, 44% Caucasians) were identified as taking antipsychotics during the study period.  Overall, 67% of beneficiaries did not have a primary indication for antipsychotic use. Only 14.1% had one or more follow-up visits, 3% were using two or more antipsychotics concurrently, 14.1% had baseline metabolic screening performed prior to filling antipsychotic prescriptions, only 14.9% had both glucose and lipid levels tests performed during the year in which antipsychotics were prescribed.  Only 0.11% of children < age 5 years had antipsychotic medications prescribed. CONCLUSIONS: Study results indicate considerable opportunity for improvement in quality of care identified in the OIG report. Several challenges exist in this area include health care access, continuity of care, and awareness of quality measures amongst providers.