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MLN Product (New); A Prescriber’s Guide to Medicare Prescription Drug (Part D) Opioid Policies

This updated publication comprises Subregulatory Guidance on Part D opioid policies, including opioid treatment programs. This publication is based on content from https://www.cms.gov/medicare/coverage/prescription-drug-coverage-contracting/improving-drug-utilization-review-controls-part-d, https://www.cms.gov/medicare/appeals-grievances/prescription-drug/plan-sponsor-notices-documents, https://www.cms.gov/Medicare/Appeals-and-Grievances/MMCAG/Downloads/Parts-C-and-D-Enrollee-Grievances-Organization-Coverage-Determinations-and-Appeals-Guidance.pdf#page=28, https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/sbirt_factsheet_icn904084.pdf#page=8

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Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: October 18, 2021

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.