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New Part D Opioid Overutilization Policies: Myths and Facts

Friday, April 19, 2019   (0 Comments)
Posted by: Katie Maher
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Source: CMS Medicare Learning Network 

CMS implemented new opioid policies for Medicare drug plans effective Jan. 1. Over the next few weeks, CMS will share common myths about these new policies and the facts for providers.


 Myth: “Medicare is requiring that all opioid prescriptions be limited to a 7-day supply at a time.”


  • Medicare Part D enrollees who have not filled an opioid prescription recently, such as within the last 60 days, will be limited to up to a 7-day supply
  • This limit does not apply to enrollees already taking opioids

Medicare Part D opioid policies are not prescribing limits, and generally don’t apply to enrollees who: have cancer; get hospice, palliative, or end-of-life care; or who live in a long-term care facility. The new policies encourage collaboration and care coordination among Medicare drug plans, pharmacies, prescribers, and patients to improve opioid management, prevent opioid misuse, and promote safer prescribing practices.

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