Blue Cross and Blue Shield of Alabama Updates Opioid Management Strategy
To Help Battle Opioid Epidemic in Alabama
FROM BLUE CROSS BLUE SHIELD OF ALABAMA
BIRMINGHAM, AL – In a continued effort to help battle the opioid epidemic, Blue Cross and
Blue Shield of Alabama is updating its opioid management strategy, effective January 1, 2020, for its commercial members. This further promotes our members’ care and safety.
Since 2015, opioid prescriptions in the U.S. and in Alabama have declined. Despite this decline, the age-adjusted rate of drug overdose deaths increased significantly in Alabama by 11.1 percent from 2016 (16.2 per 100,000) to 2017 (18.0 per 100,000). While progress is being made, this issue calls for continued action by all parties.
Beginning January 1, 2020, the following changes to Blue Cross’ Opioid Management Strategy for commercial members will be implemented:
o Members with cancer diagnoses or who are in palliative care will be exempt from the program requirements.
o As a safety precaution, members will be required to attain additional prescriber justification for continued coverage of opioids if they exceed a defined opioid dose threshold for a 180-day period. The defined dose threshold will be 300 morphine milligram equivalents (MMEs).
o If a member visits their pharmacy for a prescription refill of their opioid medication, and the member exceeds the 300 MME dose threshold, the member’s prescribing physician will need to submit a prior authorization before coverage is granted.
o Prescribing physicians are being notified of patients under their care who may be affected by this change in order to allow for continuity of care.
The well-being of our members remains our top priority. Higher doses of opioids are associated with higher risk of overdose and death. Implementing an opioid dose safety program, combined with our other strategies to improve access to medication used to treat substance abuse and drug overdoses, will add to continuing efforts to help fight the growing opioid epidemic in Alabama.
Blue Cross always encourages its members to consult their doctors about any treatments or prescription drugs they may need, and the company relies on physicians’ expertise to know what is best for their patients. Blue Cross will continue to develop and adopt actionable policies and procedures that promote safe prescribing of opioid medication and appropriate access to treatment for opioid use disorder. In addition, we will continue to collaborate with Alabama physicians and pharmacists to help curb the growing epidemic of opioid misuse by offering support, resources, and educational tools to network providers. This, combined with our strategies to improve access to medications used to treat substance abuse and drug overdoses, demonstrate our commitment to the health of our membership and Alabamians.
About Blue Cross and Blue Shield of Alabama
Blue Cross and Blue Shield of Alabama has insured Alabamians for over 83 years. Blue Cross offers coverage plans to corporations, individuals and the senior market. For more information about Blue Cross, visit AlabamaBlue.com. Connect with us on Facebook, check out our videos on YouTube and follow us on Twitter for more up-to-date information.
Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association.
