MO HealthNet Providers, please read this important message:
In an effort to address Missouri’s emergent opioid crisis, the Departments of Social Services, Health and Senior Services and Mental Health are expanding upon the Opioid Prescription Intervention (OPI) Program. The OPI Program helps ensure MO HealthNet participant safety by enforcing national standards through the use of Centers for Disease Control and Prevention (CDC) guidelines for prescribing opioids for chronic pain. For more information about the OPI Program, please reference the MO HealthNet provider OPI webpage and Governor Greitens’ press release.
Providers whose prescribing habits recently fell outside the CDC guidelines will receive a letter in the mail regarding the OPI program. If you do not receive a letter, that means you are prescribing within the guidelines.
In addition, on March 6, 2018, MO HealthNet will implement the following revisions to the short-acting opioid and short-acting combination opioid clinical edits. The revisions to the edits are listed below:
- Initial Rx for Opioid-Naïve participants will be limited to 50 MME’s
- Acute opioid therapy will be limited to 60 days AND
- Acute opioid therapy is not to exceed 90 MME’s
- Opioid therapy > 60 days will be considered Chronic and will require a PA
- Chronic Non-Malignant Pain (CNMP) diagnoses have been streamlined AND
- PA for CNMP will be limited to approved diagnoses only
DSS and MO HealthNet are committed to providing consultation, training, and assistance in an effort to improve a providers’ compliance with CDC opioid prescription guidelines. Please contact MMAC.OPICompliance@dss.mo.gov if you have questions.
For provider and policy issues regarding MHD Clinical Services Programs, including Pharmacy, The Missouri Rx Plan (MORx), Psychology, Exceptions, and Medical Precertifications, email us at: firstname.lastname@example.org.
Questions and comments regarding any other issues should be directed to: ask.MHD@dss.mo.gov