GIZMODO - In response to the opioid epidemic that is killing tens of thousands of Americans a year, the U.S. government is poised to further restrict the amount of opioids Medicare patients can have access to at any one time, via a policy that would tell pharmacies to reject certain prescriptions on the spot. But a group of doctors and researchers is pleading with officials to reconsider, saying the move would harm cancer patients and others who desperately need pain relief.
In a proposal paper released last month, the Centers for Medicare and Medicaid Services (CMS) laid out two policies affecting opioid prescriptions obtained through Medicare Part D that would come into effect starting in 2019.
One would call for a “hard edit” of opioid prescriptions made to patients on Medicare Part D that exceed a specific cumulative daily dose—the equivalent of 90 milligrams of morphine (MME). Pharmacists would be allowed to deny payment at the register for these prescriptions, while notifying the doctor(s) who prescribed the drugs. Patients would still be allowed to obtain their prescription, but only after an appeal and acknowledgment from their doctor that they qualify for certain exceptions, such as having cancer, being terminally ill, or otherwise having pre-existing approval for a higher dose.
The second proposed policy would tell pharmacists to deny prescriptions made to first-time opioid users, flagged via a database that tracks prescriptions obtained through Part-D, that provide more than a 7-day-long supply, regardless of their diagnosis.
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