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Minnesota enacts opioid prescribing limits

by
Optum for Workers' Compensation
| Jun 03, 2019

Minnesota has enacted legislation to address the opioid epidemic that includes opioid prescription and dispensing limitations for acute pain and initial prescriptions. The new policy expands upon prior narrower limitations. These new limitations take effect August 1, 2019.

Prescribing limitations
The bill, Minnesota House File 400, provides that when used for treating acute pain, prescriptions for opiates or narcotic pain relievers listed in Schedules II through IV of the state’s controlled substances schedules shall not exceed a 7-day supply for an adult and a 5-day supply for a minor. Additionally, an existing narrower provision in this same area of state law providing for a more restrictive limit (a 4-day supply), specific only to acute dental and ophthalmic pain, remains in place. But the bill clarifies that existing 4-day supply limit also includes acute pain associated with wisdom teeth extraction surgery.

Despite these limitations, the bill also provides that if, in the professional clinical judgment of the practitioner, more than these limits is required to treat a patient's acute pain, the practitioner may issue a prescription for the greater quantity.

“Acute pain" is defined as pain resulting from disease, accidental or intentional trauma, surgery, or another cause, that the practitioner reasonably expects to last only a short period of time. It does not include chronic pain or pain being treated as part of cancer care, palliative care, or hospice or other end-of-life care.

Dispensing limitations
Beyond these prescribing limits – the bill also states that no prescription for a Schedule II through IV opiate or narcotic pain reliever may be initially dispensed more than 30 days after the date on which the prescription was issued. Also, no subsequent refills indicated on a prescription for these medications may be dispensed more than 30 days after the previous date on which the prescription was initially filled or refilled. After the authorized refills have been used up or are expired, no additional authorizations may be accepted for that prescription. If continued therapy is necessary, a new prescription must be issued by the prescriber.

States’ opioid legislation trend and impact on workers’ compensation and auto no-fault
This is yet another example of the continued trend of states limiting opioid prescriptions to lessen the potential for opioid over-utilization, dependence and other related concerns. It is important to remember that these types of laws are focused on the actual prescribing and/or dispensing of these medications and not on payment for these medications by insurers or employers. Consequently, issues such as insurer authorization, coverage and reimbursement are usually not addressed.

Opioid resource for you
The Optum Workers’ Comp and Auto No-fault Government Affairs team continues to track these legislative developments. We catalogued examples of state opioid limitation bills in an opioid analgesic white paper published last year. Should you have questions on this or any other public policy developments, please contact our Government Affairs team at AskGovtAffairs@optum.com.


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