Effective January 7, 2019, the Oklahoma Health Care Authority implemented Phase 1 of a daily Morphine Milligram Equivalent (MME) limit for SoonerCare (Medicaid) pharmacy claims. It covers both short-acting and long-acting opioid formulations. Opioid MME daily totals exceeding 240 will require prior authorization (PA) with patient-specific, clinically significant reasoning why the member requires more than 240 MME per day.* This limit will gradually decrease over a six-month period, allowing providers to develop and implement tapering plans for appropriate patients. The end goal is a target of 100 MME or less.
For more information, contact NACDS’ Mary Staples at 817-442-1155.