Independence's opioid management policy will be updated to align with the
most up-to-date Centers for Medicare & Medicaid Services (CMS)
requirements. By updating our policy, we hope to help promote safe and
appropriate opioid use.
CMS Guidelines for prescribing opioids
Effective January 1, 2019, Medicare Part D plans are
required to limit opioid prescription fills to a seven-day supply for those
members who are either filling an opioid medication for the first time or who
do not regularly take opioid medications that do not require prior
authorization. A prior authorization will be required for members who are
requesting more than a seven-day supply. For opioid prescriptions that require
prior authorization, there is no seven-day grace fill without a prior
authorization.
To support efficient processing of prior authorizations, please ensure that
your office staff and on-call services are available to respond to pharmacist
and health plan calls. There are several exclusions to the prior authorization
requirement, including, prescriptions for members who are identified as being
enrolled in hospice or long-term-care (LTC), or those undergoing cancer
treatment based on prescription claims data.
For more information
If you have any questions concerning the prior authorization process, please
contact FutureScripts? at 1-888-678-7012.
FutureScripts is an independent company that provides
pharmacy benefits management services.