BCC Announces New Opioid Medication Prescribing Limits
Blue Cross Complete (BCC) implemented a cumulative edit to enhance safety and to identify members who may need additional outreach from the case management team. This edit was originally set at 120 mg per day and is in addition to other edits such as age limits, quantity limits, and the seven-day acute opioid limit, which are applied under the plan’s pharmacy benefit. The upcoming change will set the MME limit at 90 mg per day. This change aligns BCC with the fee for service cumulative MME edit transition, which will also take place as of July 1, 2021. Patients and providers are encouraged to work together to address any additional prior authorization needs when a member’s treatment requires an MME > 90 mg per day.
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