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2017-38: Opioid Prescription Policy Update

Date: 08/10/17

Effective September 12, 2017, the Louisiana Department of Health (LDH) will implement updated short-acting opioid quantity limits for Medicaid pharmacy claims for opioid naïve (no opioids in the most current 90-day period). Opioid prescriptions for chronic and naïve recipients will be decreased to a Morphine Equivalent Dosing (MED) limit of 90 mg per day.

NOTE: Prescriptions and cumulative MEDs above 90 mg per day should deny at the Point of Sale. Recipients with a diagnosis of cancer and palliative care are exempt from the MED requirements.

To mitigate administrative burden for prescribing providers, LDH is mandating the use of a standardized Opioid Analgesic Treatment Worksheet to request overrides and Prior Authorizations (PAs) for medically necessary quantities of opioids in excess of the established limits. The updated worksheet is posted on our website.

Provider Educational Resources

http://ldh.la.gov/assets/docs/BayouHealth/Informational_Bulletins/2017/IB17-2.pdf

http://ldh.la.gov/index.cfm/subhome/54

Please communicate any concerns with this policy to the LDH Medicaid’s pharmacy unit.