State Medicaid Agencies Limiting Opiod Prescriptions
Question: Why are State Medicaid agencies limiting opioid prescriptions?
Answer: According to a recent CMS report, Medicaid beneficiaries are prescribed painkillers at twice the rate of other patients and are at three to six times the risk of opioid addiction. In response, State Medicaid agencies around the country are limiting how many opioids providers can prescribe in an effort to curb the disproportionate number of beneficiaries who are at risk of overdose and death.
Although many providers are supportive of the limitations, there are those who are wary of the arbitrary numbers being placed on the number of prescriptions they are being allowed to write. Some physicians also foresee some resistance from patients worried that what they think has been effective in treating their pain may not be an option anymore. Experts agree that for any efforts to succeed, patient expectations must change.
Medicaid agencies have exempted cancer and sickle cell patients and will allow doctors to argue for their own exemptions.
When you are prescribing analgesics of any kind, follow up on the next visit as to how the use of the analgesic has impacted upon the patient’s life. For example, if you have prescribed Percocet 1 tab q4h prn pain, has the pain been alleviated for 4 hours after taken? Can the patient perform his or her activities of daily living more completely? What can the patient do now that he/she could not do prior to taking the prescription? Did the dosage have to be increased or decreased? WHY? As a best practice, your chart should reflect these findings.
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