Excessive use of opioids can lead to addiction, overdose, and death. New restrictions will be in place effective August 1, 2018 for Quartz (fully-insured) commercial members.
These restrictions will limit:
* In order to avoid interruptions in therapy, members who are currently using opioids at a dose >120 MME can continue filling their opioids until 12/1/2018.
This provides current utilizers time to obtain a prior authorization to continue therapy. Current members who are identified as needing to complete a Prior Authorization will be notified of this new requirement.
‡ Prior Authorization criteria is as follows:
ONE of the following conditions applies:
OR ALL of the following apply: