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MLN Product (New); A Prescriber’s Guide to Medicare Prescription Drug (Part D) Opioid Policies

This revised product comprises Subregulatory Guidance for Medicare Part D opioid policies, and its content is based on publically available content within at https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/RxUtilization. CMS policy or operation subject matter experts also reviewed/cleared this product. This product educates Part D plans, prescribers, and pharmacies to manage opioid utilization, prevent misuse, reduce serious adverse risks and promote safer prescribing practices. Part D plans implement safety alerts (pharmacy claim edits) to help prevent unsafe drug utilization. Pharmacists review the safety alerts when they dispense the medication. Safety alerts are typically for drug interactions, therapeutic duplication and potentially incorrect drug dosage.
Revisions to this product didn’t include any substantive content updates. The previous version of this product is available to the public and currently posted on the CMS website at https://www.cms.gov/files/document/mln2886155-prescribers-guide-medicare-prescription-drug-part-d-opioid-policies.pdf.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: October 18, 2021

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.