"Blue Cross plan targets abuse of painkillers" May 07, 2012|By Kay Lazar
Amid
a rising sea of addictions to prescription painkillers, Massachusetts’
largest health insurer is launching a policy to curb abuse by
significantly limiting the amount of pain medication most patients can
receive without prior approval from the insurer.
The program by
Blue Cross Blue Shield of Massachusetts, scheduled to start July 1, will
allow patients to fill a 15-day prescription and one additional 15-day
supply of the most common opioid drugs, such as Percocet and Vicodin,
before the insurer hits the pause button.
Future refills will
trigger a Blue Cross review and the need for assurances from the
prescriber that several requirements have been met, including patient
counseling about the significant risk for developing an addiction, and
an agreement that subsequent prescriptions will be written only by the
same physician and filled at the same pharmacy or pharmacy chain to stem
so-called “doctor-shopping.’’
Cancer patients and those with a terminal illness, who typically are
prescribed painkillers over a long term, will be exempt from the rules.
The
initiative, which insurance industry leaders say is a first in
Massachusetts, is sparking concerns from the state’s largest physician
trade group about the amount of paperwork it will add to already-swamped
health care providers. “We don’t want the primary role of physicians to
be lost by layers of administrative work,’’ said Dr. Lynda Young,
president of the Massachusetts Medical Society.
Young said her
organization realizes that painkiller abuse is rampant and is “ready,
willing, and able’’ to work with Blue Cross on ways to make its program
more manageable for physicians.
Others expressed concern that patients in pain may face undue hurdles getting treatment.
But Dr. John Fallon, Blue Cross’s chief physician executive, said the
insurer spent 18 months working with specialists in pain care and
addiction, and others, to develop a plan that balances patients’ needs
with a mission to help stem the oversupply of drugs in the marketplace.
“The alternative is to just continue the way we have been doing this and we will have more people addicted,’’ Fallon said.....
Just right me the damn prescription!
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