Companion bills in the Minnesota House and Senate will help physicians who treat patients with intractable pain, including opioid therapy, practice without fear of an investigation, disenrollment or termination for providing care that may exceed recommended prescribing limits in state or federal guidelines.
The bills, which are supported by the AMA and Minnesota Medical Association (MMA), specifically provide this safe harbor for dosages that may exceed certain morphine milligram equivalents (MME) and also provides protections against non-consensual tapering of opioid therapy by prohibiting decisions to taper based solely on MME. The bill further prohibits pharmacists, health plans and pharmacy benefit managers from refusing to fill a prescription for an opioid analgesic solely based on “the prescription exceeding a predetermined morphine milligram equivalent dosage recommendation or threshold.”
“For some patients, safe, ongoing opioid use is essential to treat their chronic pain,” said Randy Rice, MD, MMA president. “This bill balances the goals of addressing overuse of opioids and ensuring that patients with chronic pain receive the care they need.”
“For too many years, patients with pain have suffered because of inflexible, numeric thresholds on opioid therapy—thresholds that have unintentionally delayed or denied care for patients in hospice, with palliative care needs, with chronic, and other types of pain,” wrote (PDF) AMA Executive Vice President and CEO James L. Madara, MD, in a letter to the bill authors. “These bills help restore the balance between a patient and his or her physician, and the AMA joins the MMA to urge a ‘Yes’ vote.”
Read the bill.
The AMA and the Medical Society of the District of Columbia (MSDC) sent a joint letter (PDF) to the D.C. Council’s Committee on Health this week, stating strong support and urging consideration of the “Prior Authorization Reform Amendment Act of 2022.” The letter states the legislation is critically needed to rein in bureaucratic insurance requirements that delay and disrupt patient access to necessary medical care in the District of Columbia. The letter also highlights the need for legislative action given years of payer inaction despite agreeing to a consensus statement to make changes.