SEVEN DAY INITIAL OPIOID PRESCRIBING LIMITATION EFFECTIVE ON FRIDAY, JULY 22ND

This Friday, July 22, 2016 prescribing limitations will go into effect for prescribers under a new law signed as part of New York State’s efforts to curb opioid abuse.   The measure limits to seven days the prescription of Schedule II, III, or IV opioid upon initial consultation or treatment of acute pain. 

  • Under the NYS Public Health law “acute pain” is defined to mean pain, whether resulting from disease, accidental or intentional trauma or other cause that the practitioner reasonably expects to last only a short period of time. Such term SHALL NOT include chronic pain, pain being treated as part of cancer care, hospice or other end-of-life- care or pain being treated as part of palliative care practices.  
  • The new limitation applies to the initial prescription ONLY.  The measure gives flexibility to the prescriber to, upon any subsequent consultations for the same pain, issue  any appropriate renewal, refill or new prescription for the opioid or any other drug consistent with existing 30-day or 90-day statutory limits for Schedule II, III and IV medications. 
  • The measure also limits application of co-pays for the limited initial prescription of an opioid to either (i) proportionate amount between the copayment for a thirty day supply and the amount of drugs the patient was prescribed or the equivalent to the copay for the full thirty-day supply provided that no additional copays may be charged for any additional prescriptions for the remainder of the thirty-day supply. 
  • The New York State Department of Health has put into place temporary procedure for billing for the Medicaid Fee For Service Program.   The department’s letter can be found HERE. 
  • The letter does stipulate that pharmacists are NOT required to verify with the prescriber whether an opioid prescription writer for greater than a seven-day period. 
  • Additional information on opioids and this law may be obtained by contacting the NYS Department of Health’s Bureau of Narcotic Enforcement at 1-866-811-7957 or click HERE.