Opioid Prescribing Change for Washington Medicaid Patients

To help curb the public health crisis of opioid addiction in Washington State, the Health Care Authority (HCA) began on Nov. 1, 2017 to limit the quantity of opioids that providers can prescribe to Apple Health clients for short-term use. The policy is a tool to prevent misuse and addiction, an opportunity to promote safe prescribing practices, and a direct response to Governor Inslee’s executive order to combat the opioid crisis.

The policy sets the following limits:

For people ages 20 or younger: 18 tablets or capsules (about a three-day supply)
For people ages 21 or older: 42 tablets or capsules (about a seven-day supply)
Prescribers are able to override the limits if they feel it is medically necessary. In addition, the policy exempts:   

Patients who are undergoing active cancer treatment or who are in hospice, palliative care, or end-of-life care.
Patients who are already on chronic (ongoing) opioid therapy.
The policy aligns with U.S Centers for Disease Control and Prevention guidelines.

To learn more about this visit https://www.hca.wa.gov/billers-providers/programs-and-services/opioids

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