Effective November 1, 2017, OptumRx, the pharmacy benefit manager for UnitedHealthcare Employer and Individual, will administer Point of Sale (POS) messaging to members that fill opioid prescriptions that exceed 180 mg of Morphine Equivalent Dose (MED). The cumulative total daily MED value will be calculated based on the conversion factors defined by the Centers for Disease Control and Prevention (CDC) and all opioid drugs prescribed for the member over a period of time, which includes incoming claims and active claims history.

If an opioid claim is submitted which results in a total calculated daily MED value exceeding 180 mg, the claim will pay but the following conflict message will be displayed to the pharmacy at point-of-sale:

                                                            TOTAL OPIOID DOSE PA REQ AS OF 1/1

*Please see attached for more information.