Independence's opioid management policy will be updated to align with the most up-to-date Centers for Medicare & Medicaid Services (CMS) requirements. By updating our policy, we hope to help promote safe and appropriate opioid use.

CMS Guidelines for prescribing opioids

Effective January 1, 2019, Medicare Part D plans are required to limit opioid prescription fills to a seven-day supply for those members who are either filling an opioid medication for the first time or who do not regularly take opioid medications that do not require prior authorization. A prior authorization will be required for members who are requesting more than a seven-day supply. For opioid prescriptions that require prior authorization, there is no seven-day grace fill without a prior authorization.

To support efficient processing of prior authorizations, please ensure that your office staff and on-call services are available to respond to pharmacist and health plan calls. There are several exclusions to the prior authorization requirement, including, prescriptions for members who are identified as being enrolled in hospice or long-term-care (LTC), or those undergoing cancer treatment based on prescription claims data.

For more information

If you have any questions concerning the prior authorization process, please contact FutureScripts^? at 1-888-678-7012.

FutureScripts is an independent company that provides pharmacy benefits management services.