CMS Changes Opioid Policy Proposal Amid Criticism

April 4, 2018

CMS recently submitted a final rule that included changes to a prior measure aimed at reducing opioid abuse that received backlash from the physician and payer communities.

The Agency’s draft proposal would have prohibited dispensing of high-dose opioid supplies without a patient receiving special permission from insurance providers. The high-dose formulations included in the policy were any prescription of 90 milligrams of morphine per day or more.

CMS wrote that the proposal “was strongly opposed by nearly all stakeholder groups for a variety of reasons.”

CMS made the change after evidence showed that a hard cut-off of high dose opioid prescription would not significantly reduce opioid misuse but would potentially adversely impact patients who require the pain management medication.

Under the final rule, when a pharmacist receives a prescription for high-dose opioids they will be required to contact the prescriber, document the contact, and receive verbal approval from the prescriber before filling the prescription.

David Costill

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