04/16/18 Medicare Announces New Guidelines on High-Dose Opioids

Aiming for an “overall reduction in opioid overuse and overdoses,” Medicare announces starting next year there will be new limits for high-dose opioid prescriptions.

APRIL 12, 2018

The Medicare announcement—part of the 2019 Medicare Advantage and Part D Rate Announcement and Call Letter— sets limits for opioid-naive patients on seven-day prescriptions, and notes the expansion and combination of the Overutilization Monitoring System and other government facets to identify “high-risk” opioid users, defined as using high levels of opioids from multiple sources, and “potentiator” users, who are using other medications (e.g., benzodiazepines) that increase the risk for adverse effects from opioids.

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