[ad_1]
KNOXVILLE, Tennessee (WATE) – The new crackdown on painkillers will begin in just under four months. BlueCross BlueShield, of Tennessee, announced on Thursday that it would no longer cover OxyContin prescriptions as a means of impacting the opioid crisis.
OxyContin will be replaced by drugs designed to reduce the risk of abuse, Xtampza and Morphabond.
Coverage changes will take place on January 1, although Medicare, TennCare and people with cancer or end-of-life treatments are not affected.
"These efforts are motivated by the desire to ensure the safety and well-being of everyone in the state, not just the members we serve. Our clinical and social approach aims to ensure that BlueCross members opioid for their medical conditions while limiting the risks of abuse and abuse, "said Dr. Andrea Willis, Chief Medical Officer of BlueCross.
As of January 1st, the following changes will include:
- A seven-day quantity limit for short-acting opioid prescriptions issued to members who receive the drug for the first time.
- A higher prior authorization requirement for prolonged use of opioids for short-term action. Specifically, this will impact those who use more than 30 days of short-acting medication over a 90-day period.
- A lower threshold for the equivalent morphine milligram (MME) dose, with an authorization required for more than 120 milligrams of opioids per day.
- Removing OxyContin from the list of medications covered, to replace with less likely drugs to be abused.
- Drug combination alerts for clinical teams and providers that highlight inappropriate or dangerous drug combinations to promote appropriate use.
- Adding an advantage for alternative treatment of pain.
Druggist Josh Gass from Belew Drug explained how these changes could impact people with chronic pain.
"This change to the BlueCross BlueShield form does not prevent you from getting the product or the doctor who prescribes it," said Gass, "they just say they will not cover it anymore."
This means that patients who use OxyContin, a sustained-release medication, will pay for their medications out of pocket. This can range from a few hundred dollars to a thousand dollars depending on dosage and duration.
"I believe that this decision to use these two new products can certainly help and help solve some of the problems related to opiates, but I think we can not limit our efforts only with form changes. of the health care process, "said Gass.
BlueCross BlueShield says that they are working to educate all their network providers about the changes. They also work with doctors on what is called a "decision support tree", ensuring that best practices are followed when prescribing opioids.
On July 1, Tennessee has adopted one of the most stringent and aggressive policies in the nation. Governor Bill Haslam's TN Together Act limits the duration and dosage of opioid prescriptions. The plan focuses on three key areas: prevention, treatment and enforcement.
Source link
