4

Jan

2017

OptumRx: Opioid Use Following Buprenorphine (DDI POS Edit)

Effective 1/1/2017

The Center for Medicare & Medicaid Services (CMS) 

OptumRx Medicare Plans

Read More...

28

Dec

2016

Argus: Bulletin Communication #44MG16 - 2017 Medicare Opioid Overutilization Edits and POS Override

Effective January 1st 2017

To comply with new regulations from the Centers for Medicaid and Medicare Services (CMS), most Medicare Part D Plans and some commercial plans will be implementing new edits to help manage opioid use within their Medicare populations.

*Please see attached PDF for more information.

Read More...

16

Dec

2016

OptumRx: Opioid Use Following Buprenorphine (DDI POS Edit)

Effective January 1st 2017

Effective January 1, 2017, CMS will require Medicare plan sponsors to implement a soft point of sale (POS) reject when an opioid prescription is presented following the initiation of buprenorphine for the treatment of opioid use disorder. An enhancement to the Drug-Drug Interaction (DDI) cDUR edit will be turned on to reject opioid claims when a member has a recent history of treatment with buprenorphine or buprenorphine containing products indicated for opioid dependence.

*Please see attached PDF for more information.

Read More...

1

Dec

2016

OptumRx: The Center for Medicare & Medicaid Services (CMS) - Opioid Use Following Buprenorphine (DDI POS Edit)

Effective January 1st 2017

Effective January 1, 2017, CMS will require Medicare plan sponsors to implement a soft point of sale (POS) reject when an opioid prescription is presented following the initiation of buprenorphine for the treatment of opioid use disorder. An enhancement to the Drug-Drug Interaction (DDI) cDUR edit will be turned on to reject opioid claims when a member has a recent history of treatment with buprenorphine or buprenorphine containing products indicated for opioid dependence.

*Please see the attached PDF for more information.

Read More...

15

Nov

2016

CVS Caremark: Medicare Part D - Improving Drug Utilization Review (DUR) Controls

Effective January 1st 2017

Effective January 1, 2017, CVS Caremark will add Buprenorphine/Opioid to its DUR edits. Buprenorphine sublingual (SL) tablets and buprenorphine/naloxone SL film/tablets are indicated for the treatment of opioid dependency. Use of these products should be part of a complete treatment plan, which includes counseling and psychosocial support.


*Please see attached PDF for more information.

Read More...
1234 Last