Pew Comments on Proposed Regulations for Medicare Part D Drug Management Programs

Proposal would do little to curb opioid misuse in the Medicare population

Pew Comments on Proposed Regulations for Medicare Part D Drug Management Programs
Pew Comments on Proposed Regulations for Medicare Part D Drug Management Programs

On Jan. 16, The Pew Charitable Trusts’ substance use prevention and treatment initiative submitted comments to the Centers for Medicare & Medicaid Services on proposed regulations for Medicare Part D that would allow insurers to use drug management programs to protect beneficiaries from opioid-related harms. Pew’s comments outline why the regulations would fail to protect patients at risk for such harms and offer recommendations for strengthening the proposal. 

Opioids
Opioids
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Medicare Must Do More to Protect Beneficiaries Susceptible to Opioid-Related Harms

The agency’s recent proposal would do little to curb the opioid crisis in this population

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In November, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule intended to protect Medicare beneficiaries who are at risk from opioid misuse. The rule sets expectations for insurers developing drug management programs known as patient review and restriction (PRR) programs, which are used to identify at-risk patients and assign them to designated prescribers and/or pharmacies for their controlled substance needs. While welcome, this rule as proposed fails to adequately protect these patients, and must be improved.