ISMS Urges DHFS to Reconsider Opioid Prescribing Limitations for Patients

January 6, 2023

ISMS is advocating for Medicaid patients in light of the Illinois Department of Healthcare and Family Services (DHFS)’ recent notice, Initial Prescription Limit – Changes to Maximum Days’ Supply.

DHFS’ new policy, which focuses on opioid and benzodiazepine prescribing limits, runs counter to the Centers for Disease Control and Prevention’s guidance. While ISMS shares the Department’s goal of reducing abuse of controlled substances, including opioid analgesics, we believe policies must balance patients’ needs for comprehensive pain management services with efforts to promote appropriate prescribing.

As Illinois doctors already know, the nation’s opioid prescription-driven epidemic has been replaced by the unprecedented, multi-factorial and much more dangerous overdose and drug epidemic driven by heroin and illicitly manufactured fentanyl, fentanyl analogs and stimulants. We can no longer afford to view increasing drug-related mortality through policy lenses that suggest prescribed opioids are the root of the problem.

ISMS strongly urges DHFS to withdraw its new policy and to instead consider a broader view of how to help ensure patients have access to evidence-based comprehensive care that includes multidisciplinary, multimodal pain care options.

Scheduled to take effect Feb. 1, 2023, the Department’s new policy limits the initial fill for opioids to a maximum of a five-day supply and the initial fill for benzodiazepines to a maximum of a 14-day supply. After the initial fill, prescriptions for these drugs may be filled for a 30-day supply.

ISMS will keep you informed of any new developments.

Read ISMS’ December letter to DHFS.

If you have questions, please contact the ISMS Health Policy Research and Advocacy team by email.