News, Skilled Nursing Facility

CMS proposal could place limits on filling opioid prescriptions for Medicare beneficiaries

New strategies to combat opioid overuse in seniors proposes placing limits on the amount of morphine milligram equivalent (MME) that a pharmacy can prescribe, as well as the prescription length, according to a call letter released by CMS last week. This proposal is part of CMS’ continued oversight through the overutilization monitoring system.

By expecting pharmacies to implement “hard formulary levels” of 90 MME at point-of-sale that can only be overridden by the sponsor, CMS hopes to trigger a conversation between the physician, patient, and the Medicare plan to determine the most effective prescription plan. The proposal would also implement a 7-day supply allowance, and is considering limiting the number of pills allowed to be prescribed in an initial prescription for acute pain.

“Given the danger of combining opioids and benzodiazepines,” says CMS letter, the agency will also seek to address this problem in individuals who are 18 years and older.

Comments regarding these changes can be submitted until Monday, March 5, 2018. To read the full letter, which addresses additional topics related to Medicare Advantage and Medicare Part D, click here.