CMS Proposes Opioid Prescribing Limits for Medicare Enrollees

I'm skeptical, but we'll see......

https://goo.gl/evHPkr

Pharmacies would have new limits on filling opioid prescriptions for Medicare beneficiaries under regulations proposed Thursday by the Centers for Medicare & Medicaid Services (CMS).

"We are proposing important new actions to reduce seniors' risk of being addicted to or overdoing it on opioids while still having access to important treatment options," said Demetrios Kouzoukas, CMS deputy administrator and director of the Center for Medicare, on a phone call with reporters. "We believe these actions will reduce the oversupply of opioids in our communities."

Under the proposal, Part D plans would implement so-called "hard formulary levels" at pharmacies which would restrict the amount of opioids that beneficiaries could receive. "These are triggers ... [that] can prompt conversations between physicians, patients, and plans about appropriate opioid use and prescribing," Kouzoukas said. "The trigger can only be overridden by the plan sponsor after efforts to consult with the prescribing physician." The safety level would be a 90 morphine-mg equivalent (MME) with a 7-day supply allowance.

The proposal also would limit the number of pills in an initial prescription for acute pain, "possibly with or without a daily dose maximum," he said, adding that CMS is accepting comments on the proposals through March 5. In addition, CMS "expects sponsors to implement 'soft' safety edits" to flag a potential problem, although those could be overridden by the pharmacist.