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AMA Responds to Walmart’s “Refusal to Fill” Policy

The American Medical Association (AMA) continues to express its concerns over Walmart's corporate prescription opioid restriction policy in its recent letter to Walmart's Chief Medical and Analytics Officer. The new policy limit opioid prescriptions to seven days or 50 morphine milligram equivalents (MME) has caused harm to patients with acute, palliative, cancer-related, chronic pain and other medical conditions requiring amounts or doses greater than the corporate policy. According to the AMA, "this policy has disrupted legitimate medical practices that receive form letters telling them their prescribing rights under state law will be superseded by a Walmart-created algorithm that deems a physician unfit to prescribe."

AAPM has echoed AMA advocacy efforts on this subject. In 2018, AAPM Past President, Steven P. Stanos, DO, traveled to Walmart headquarters with an AMA-led contingency to discuss these issues including ensuring access to comprehensive pain care; opioid prescribing guidelines; pain care and stigma; and reducing opioid misuse and diversion. Later in the year, AAPM's AMA Delegates joined other pain and palliative medicine societies to rally the AMA House of Delegates to adopt a policy opposing the misuse of the 2016 CDC Guideline.

Further, AAPM's advocacy efforts around the misapplication of the CDC Guideline for Prescribing Opioids for Chronic Pain has been ongoing, and included the AAPM Foundation consensus panel report that addressed the challenges of implementing the CDC Guideline. In April, the CDC issued an advisory cautioning against the misapplication of its guideline, following the publication of an editorial in The New England Journal of Medicine. The editorial referenced the AAPM Foundation consensus panel report and recognized that some policies and practices derived from the CDC Guideline are inconsistent and go beyond its recommendations, causing undo difficulty for patients and their providers. Furthermore, the editorial acknowledges the need for improved patient access and provider reimbursement for multidisciplinary pain care.

AAPM continues to advocate for the pain medicine and its members, continuing to serve as the voice for pain clinicians in national efforts to address the opioid crisis and promote the importance and adoption of patient-centered multidisciplinary care.

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