Blue Cross Blue Shield of Massachusetts Clamps Down on Opioid Prescriptions

From ACEP News:

Blue Cross Blue Shield of Massachusetts is implementing what it says are industry-leading policies to restrain the abuse of opioid medications among its members, including a requirement that new opioid drug prescriptions written for quantities of longer than 30 days must be accompanied by a medical authorization before coverage is approved. The new policies become effective July 1.

BCBS Massachusetts said in a statement that it developed the new policies after an internal review showed that 30,000 of its members received prescriptions for short-acting pain killers lasting longer than 30 days, “a practice that many experts believe increases the chances of drug misuse, dependency, and diversion.”

Massachusetts has seen a significant increase in opioid-related deaths and hospital stays over the past decade mainly due to heroin use, but in part because of the increased availability, misuse, and abuse of prescription pain killers, according to the health plan.

The new policies also mandate that all prescriptions for a short-acting opioid be obtained from just one prescriber or prescribing group and that scripts must be filled at one designated pharmacy or pharmacy chain. The restrictions appear to go further than those set by other private insurers, which first determine if a potential problem exists through claim reviews before restricting members’ access to opioid coverage.

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