decisionhealth Newsletters, Coder Pink Sheets - 2019 Issue 1 (January)
Compliance: Prepare a plan at your practice now to prevent opioid prescription snafus
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Article Overview
This compliance-focused article covers an upcoming Medicare Part D policy change affecting initial opioid dispensing, the patient groups excluded from the edit, and practice workflow preparation. It is aimed at clinicians, office managers, billing/coding staff, and compliance personnel who need to understand how the Part D change may affect prescribing, pharmacy processing, and plan communications. The article also points readers to CMS resources and discusses general options for requesting coverage determinations when a longer supply is needed.
Why This Topic Matters
Practices that prescribe opioids to Medicare Part D patients may need to adjust internal processes to reduce delays, confusion, and pharmacy rejections. Understanding the scope of the policy and the available plan-related processes can help offices prepare before the effective date.
Article Sections
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Policy overview and scope
Introduces the Medicare Part D opioid dispensing change, the timing of implementation, and the broad patient populations affected or excluded.
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Create a plan now
Discusses practice preparation, communication with prescribers and pharmacies, and general options for handling prescriptions that may be impacted by the edit.
What You Will Learn
- What the article says about the upcoming Medicare Part D opioid dispensing change
- Which general patient groups are affected or excluded
- What kinds of practice workflow preparation are discussed
- What CMS-related resources are referenced for follow-up
Who Should Read This
- Physician practices
- Prescribers
- Compliance staff
- Billing and coding staff
- Practice managers
- Pharmacy-facing office staff
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