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Medicare Part D

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New Part D Opioid Overutilization Policies

CMS implemented new opioid policies for Medicare drug plans effective January 1, 2019. Medicare Part D enrollees who have not filled an opioid prescription recently (within the last 60 days) will be limited to up to a 7-day supply. The limit does not apply to those already on opioids. The new guidelines are not prescribing limits and are meant to encourage collaboration and care coordination among Medicare drug plans, pharmacies, prescribers, and patients to avoid opioid misuse.

In conjunction with the new policies, CMS sent information letters to physicians and have created several training documents and resources for physicians, pharmacists and patients. View the prescribers guide to the Medicare Part D Opioid Overutilization Policies for 2019.

Additional information can be found at CMS.

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American Academy of Pain Medicine