As you are aware, prescription medications are an important part of improving the quality of life for millions of Americans living with pain. However, one of the most serious public health problems in our country is the over dependence on these medications, particularly prescription opioid pain medications.

Beginning October 1, 2017, The Health Plan will begin effecting an Opioid Management Program to help combat the growing abuse of opioids. This program will apply to commercial and select ASO clients.

As a part of this program, we will be implementing the following changes regarding prescribing and dispensing of opioid medications:

  • The first fill of an opioid medication for an opioid naïve patient will be limited to a 5-day supply.
  • Prior authorizations will be required for the following:
    1. Greater than 80 morphine milligram equivalents of opioids per day.
    2. Opioid usage greater than 90 consecutive days.
    3. Opioids used in combination with CNS depressants.
    4. Long-acting opioid medications.

If you have questions, please contact THP pharmacy services at 800.624.6961 ext. 7914.