Important Medicare Part D Opioid Edits Take Effect Jan. 1

The Centers for Medicare & Medicaid Services (CMS) finalized new opioid policies for Medicare drug plans starting on Jan. 1, 2019. The new policies include improved safety edits when opioid prescriptions are dispensed at the pharmacy and drug management programs for patients determined to be at risk for misuse or abuse of opioids or other frequently abused medications. Don’t be caught by surprise!

Here are just a few of the changes:

Opioid Safety Edit

• Limits new patients to 7 day supply (hard edit)

DUR Edits

• Limits 90 MME per day (soft edit-can possibly be overridden at the pharmacy)
• Opioid and Benzo edit (soft edit)
• Duplicate long-acting opioid edit (soft edit)

Download information now so that you are ready for the new year.