https://www.news4jax.com/health/opioid-crisis/medicaid-program-limiting-opioid-prescriptions
TALLAHASSEE, Fla. – As lawmakers consider proposals to limit opioid prescriptions, Gov. Rick Scott’s administration is taking steps to do the same in the Florida Medicaid program.
The Agency for Health Care Administration announced last week that, effective Monday,
prescriptions for narcotics in the Medicaid program will be limited to a maximum seven-day supply.
Medicaid also is no longer requiring prior authorization for certain medication-assisted treatments to help fight opioid addiction including monthly shots of the drug Vivitrol.
The changes, among others, are being made to “assist in the prevention and treatment of substance use disorders,” the agency said in a Medicaid alert about the decisions.
Proponents say the shifts in policy will go a long way to help the state curb the use of opioids, which are narcotic pain medications and have caused widespread overdoses. In 2016, heroin caused 952 deaths in Florida, fentanyl caused 1,390 deaths, oxycodone caused 723 deaths, and hydrocodone caused 245 deaths. Those statistics led Gov. Rick Scott in May 2017 to declare a state of emergency.
The Medicaid adjustments, in part, track legislative proposals for other patients. Those proposals would limit prescriptions for opioids to three-day supplies but also allow for up to seven-day supplies if physicians deem it medically necessary.
The new Medicaid policy also allows an exemption to the seven-day cap if physicians believe it’s medically necessary to prescribe more. Unlike the legislative proposals, though, there isn’t a limit on medically necessary prescriptions.
Supporters say limiting opioid prescriptions will help stem the use of opioids.
But many surgeons and physicians don’t like the limits. Florida Medical Association General Counsel Jeff Scott last week urged lawmakers to allow for exceptions to the limits in situations such as when patients undergo major surgery, have cancer or are in hospice.
Chris Nuland, a lobbyist for the Florida Chapter of the American College of Surgeons, said he doesn’t “like the Medicaid policy,” but said it’s better than what is under consideration by the Legislature.
“While the surgeons dislike arbitrary limits, at least the Medicaid policy acknowledges there will be cases for which a larger prescription is appropriate,” said Nuland.
Prescribing and usage guidelines for Medicaid are determined in part by panels known as the Pharmaceutical and Therapeutics Committee and the Drug Utilization Review Board, as well as the Agency for Health Care Administration, which has oversight of the Medicaid program.
The Pharmaceutical and Therapeutics Committee meets quarterly and is charged with maintaining a preferred drug list, or the list of approved medications for specific medical conditions. The Drug Utilization Review Board approves drug-use criteria and standards for drug use.
In addition to limiting prescriptions, the Medicaid program also is eliminating prior-authorization requirements for medication-assisted treatment, specifically naltrexone tablets and Vivitrol, which was added to the preferred drug list after a Pharmaceutical and Therapeutics Committee meeting in January.
Additionally, effective Feb. 5, Medicaid will reimburse for a seven-day supply of Suboxone film, which contains buprenorphine and naloxone, or buprenorphine tablets for pregnant or nursing mothers without prior authorization.
The changes impact only the Medicaid program, which provides care to about 4 million Floridians, 85 percent of whom are enrolled in managed-care plans.
In the legislative proposals for other patients, a Senate bill (SB 8), filed by Sen. Lizbeth Benacquisto, R-Fort Myers, would eliminate prior-authorization requirements for medication-assisted treatment. The House version (HB 21), filed by Rep. Jim Boyd, R-Bradenton, would not.
It can take weeks to obtain prior authorization for medication-assisted treatments, leaving patients without access to the medications that can help them recover.
Mark Fontaine, executive director of the Florida Alcohol and Drug Abuse Association, told The News Service of Florida that eliminating the prior-authorization requirements for medically assisted treatment is a step in the right direction.
The medications, he said, “help stabilize brains and move people toward a path to recovery.”
Leave it to those politicians in FL… according to THEIR OWN NUMBERS … in 2016 there was a total of 3410 opiate related deaths and abt 70% of those deaths were from ILLEGAL OPIATES… so what does the bureaucrats do… clamp down on the legal opiates and will cause those people suffering from moderate-severe intractable chronic pain.
Using national averages, would suggest that there are 2-3 million of those pts in FL and of course they are picking on those who are the poorest (Medicaid pts) who can least afford legal representation and maybe not even afford transportation to go to the state house in Tallahassee to protest.
Of course, Gov Scott is “tapped out” on running for re-election…
Filed under: General Problems
The shit is about to hit the fan; these “politicians”, who, are clearly opportunistic liers when it comes down to Spin, in order to manipulate their own way into a Gov insurance plan, and once-in, pass the buck, could give a Rats-Ass about the desperate fools-who they conned their way in, but, they are too ignorance and foolish, to believe that it’s a memorable deal. Remembering former candidates, I should have chosen Sara Palen, as the Death-Camp senario is on key. Our country has taken a noise-dive into a warped monologue of played-out shit. The majority of people I know, are discusted to their bones.
Stats are BOGUS! That is BS!
They are not all government stats. And they back each other up. Some of my work was,with those receiving Medicaid. For various,reasons, those on Medicaid are more inclined to abuse drugs. than those with other insurance or self pay patients.
This is a sham. This is a disturbing distraction from the fact that certain groups are being targeted by “open” gov initiatives to oppress and make us more vulnerable to stress, paranoia, and expedited illness through unethical assaults.
Please join the Florida Pain Advocacy Group on FB and join with fellow Floridians to fight for pain control. The Governor needs to be met with and shown #patientsNOTaddicts. There’s a friendly state legislator and the medical associations are trying to help, but they need pain patients speaking out and meeting with them.
https://www.facebook.com/groups/170756076994374/
Most State Medicaid Programs began limiting opiates a year or so ago. It does not require any law be passed or changed. It is a policy change
new laws and/or policies should not be violating existing laws and/or discriminates against certain classes or segments of the population. Unfortunately, there is no automatic checks/balances in our system assures that existing laws are not violate or they cause discrimination on protected classes.
These new policies do not discriminate against anyone.
The State Of Tennessee Medicaid Program changed their policies regarding what opiates could be prescribed and the dosage a while back. They also changed their policy on amphetamines being prescribed to Medicaid Recipients that were also prescribed opiates.
Stats have shown those receiving Medicaid are more likely to abuse drugs and possibly become addicted than others
Read what you wrote again. Especially the very last. Studies show those on Medicaid may POSSIBLY become addicted more than others. That’s a maybe. No studies can prove what someone thinks might possibly happen. And if you can’t understand how that discriminates. So if someone becomes disabled who has had private insurance all their life, no drug problem and now they’re on Medicaid why would they “possibly become addicted more” ? What’s next? Studies show those with BCBS are more likely to become alcoholics? Because your statement makes as much sense. And no I’m not and have never been on Medicare. How about some links to these studies?
Medicaid and Medicare are two different programs.
I will post the links tomorrow when I am on another device