Effective 1/1/2018, Regence Health Plans, Asuris Northwest Health, and Bridgespan prescription drug plans implemented a utilization management program which limits the duration of therapy of immediate release (IR) single and combination opioid agents, including tramadol products. Coverage for these agents are limited to a maximum of 7 days total of therapy within a 60-day period. Use of an IR opioid product for greater than 7 days requires pre-authorization. This 7-day limit accumulates across IR opioid products.

Covered Person’s may have up to 2 grace fills (each for up to 7 days of therapy) to allow access during the pre-authorization submission and review process. Once the grace fill limit is exceeded claims will no longer process unless a pre-authorization has been obtained.

*Please see attached for more information.