Effective January 1, 2018, the morphine milligram equivalent (MME) edit (formerly known as the morphine equivalent dose or MED edit) criteria will be updated for all Navitus clients. The average daily MME used for the edit will be lowered from 120 mg to 100 mg. This updated criteria will identify members who have active opioid prescriptions with a cumulative daily morphine milligram equivalent (MME) of 100 mg or greater, prescribed by two or more providers and filled at two or more pharmacies. The purpose of this edit is to alert the dispensing pharmacist to potential overutilization issues. The edit will continue to return a soft rejection, allowing the pharmacist to review the clinical appropriateness of the claim, perform any prescriber outreach (as applicable) and when clinically appropriate, override the rejection at the point-of-sale using standard NCPDP DUR codes. In addition to the soft rejection, pharmacies will receive the following message:

"High Morphine Mg Equiv, Mult Prescriber/Pharmacy."

*Please see attached for more information.