CMS Fixes Controversial Opioid Proposal in Final Rule

WASHINGTON, April 4 -- The American Enterprise Institute issued the following news release:

The Centers for Medicare and Medicaid (CMS) just released a final Medicare rule that alters a controversial proposal that would have required patients to receive special permission from private insurance companies to receive a high dose of opioids, equivalent to 90 morphine milligram equivalents (MME) per day or more.

While the proposal was intended to combat the opioid epidemic, many had expressed disapproval toward the proposal, pointing out that the proposal could have negative implications, such as depression or loss of function, in patients who have taken opioids for long periods of time. After receiving feedback from patients and public health experts, including AEI Resident Scholar and practicing addiction psychiatrist Sally Satel, MD, CMS concluded that the 90 MME-per-day rule would have little positive impact in combating the opioid epidemic. Dr. Satel wrote about the previous proposal:

"For some, the implementation of dose reduction will actually worsen their health. As we have heard from patients across the country, forcible dose reductions often result in rupture of the care relationships as pain patients find themselves without anyone who can continue medicines that they rely on. ... Data already show that reducing pills is not the same as saving lives."

Read her full piece, "Pill limits are not a smart way to fight the opioid crisis."

The final policy requires pharmacists to check with providers before fulfilling a 90 MME-per-day or more prescription. The proposal is designed to create a faster, more efficient process for pharmacists, patients, and prescribers.

Dr. Satel is available to comment on the CMS' final Medicare rule, as well as the outlook for the opioid epidemic and ways to combat it.

To arrange an interview, please contact AEI Media Services at [email protected] or 202.862.5829.