Require the use of opioid prescribing guidelines
Recommendation
The Centers for Medicare and Medicaid Services (CMS) should incorporate the Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain into the Conditions of Participation (CoPs) for the Medicare and Medicaid programs and require all prescribers associated with Medicare Part D plans to take training on pain prescribing that follows the guidelines.[1]
Background/summary
In 2016, the CDC developed a “Guideline for Prescribing Opioids for Chronic Pain.”[2][3] To align with new evidence, the CDC updated its 2016 recommendations in the 2022 “Clinical Practice Guideline for Prescribing Opioids for Pain”[3] to go beyond recommendations for chronic pain (>3 months) and included management of acute (<1 month) and subacute (1-3 months) pain, as well as recommendations for primary and non-primary care prescribers.[3] In an effort to improve the safe prescribing of these drugs, the Food and Drug Administration (FDA) also incorporated guidelines, including the CDC guidelines, into its Risk Evaluation and Mitigation Strategies (REMS) for providers who prescribe opioid analgesics.[4]
CMS should require the use of similar guidelines for prescribers.[1] Medicare prescription drug plan sponsors are required to develop drug management plans (DMPs) for individuals with a history of an opioid-related overdose.[3] However, there is no required training for individuals who prescribe opioids for pain in Medicare. In addition, CoPs for Medicare and Medicaid do not include recommendations for prescribing opioids for pain.[5] To align with the CDC’s updated recommendations for prescribing opioids for pain, CMS should require trainings for prescribers and incorporate the guidelines into CoPs.[1]
citations
1. The Kennedy Forum. Recommendations of Congressman Patrick J. Kennedy to the President’s Commission on Combating Drug Addiction and the Opioid Crisis. Last Accessed October 2017.
2. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. CDC Guideline for Prescribing Opioids for Chronic Pain. Last Accessed March 18, 2016.
3. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. CDC Clinical Practice Guideline for Prescribing Opioids for Pain. Last Accessed November 4, 2022.
4. U.S. Department of Health and Human Service, Food and Drug Administration. FDA’s Opioid Analgesic REMS Education Blueprint for Health Care Providers Involved in the Treatment and Monitoring of Patients with Pain. Last Accessed September 2018.
5. U.S. Department of Health and Human Service, Centers for Medicare & Medicaid Services. Conditions for Coverage (CfCs) & Conditions of Participation (CoPs). Last Accessed December 1, 2021.