Missouri enacts opioid prescribing limits

| Aug 09, 2018

The Missouri Legislature, in the waning hours of its session, passed legislation containing numerous changes to existing laws governing medical and pharmacy practices. One tucked away segment of the bill imposes prescribing restrictions for initial prescriptions of opioids to treat acute pain.

While pieces of the bill have varied effective dates, the new prescribing restrictions take effect August 28, 2018.

Senate Bill 826 inserts new language into the law clearly defining “acute pain” and “initial prescription” as well as new prescribing restrictions. The new prescribing restrictions enact a limitation of a 7-day supply on all initial prescriptions of opioids utilized to treat acute pain. Like similar prescribing restrictions recently enacted in other states, this bill addresses prescribing practice(s) state-wide and, with respect to the opioid prescribing limit, does not address issues concerning insurance carrier coverage, authorization or liability for payment.

The law also contains various exemptions from the prescribing limits allowing for the prescriber to make a medical necessity judgment for amounts greater than seven days and for cancer-related care and end-of-life treatment.

Key opioid prescribing restrictions

  • A practitioner (other than a veterinarian) shall not issue an initial prescription for more than a 7-day supply of any opioid controlled substance upon initial consultation and treatment of acute pain.
  • Prior to an initial prescription for any opioid controlled substance, a practitioner shall inform the patient of the risks associated with the opioid prescribed.

Text of the bill can be viewed here.

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