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New Concurrent Opioid and Benzodiazepine Prior Authorization Program for Select Illinois Medicaid Members

Posted October 26, 2018

Due to the opioid health crisis, many health care groups, including those participating in Blue Cross and Blue Shield of Illinois (BCBSIL) networks, have been taking this crisis and our role in addressing it seriously. Data shows there are more than 115 Americans dying each day from an opioid overdose.1 Recent data also shows that more than 30 percent of opioid overdose events involve the use of opioid and benzodiazepine prescription medicines taken at the same time.2

Using these drugs together can cause too much sedation and respiratory depression, which are the common side effects of these medicines.2 Long-term use of these medicines at the same time also drastically raises the chance of an opioid-linked overdose.3

To help support safe and effective opioid prescription use by our members, BCBSIL will now require prior authorization approval for members with Blue Cross Community Health PlansSM (BCCHPSM) prescription drug coverage. BCCHP members who use both an opioid and a benzodiazepine medicine at the same time will require prior authorization approval for coverage consideration.

Providers can access, complete and submit the prior authorization form electronically from the CoverMyMeds login page or MyPrime.com, or, via fax to 877-480-8130 or call 866-202-3474.

Members and providers can call the Member Services number on the member’s ID card for any questions about this change.

1Hernandez, Inmaculada, et al. “Association Between Concurrent Opioid-Benzodiazepine Use and Risk of Opioid-Related Overdose.” JAMA, American Medical Association, 22 June 2018, jamanetwork.com/journals/jamanetworkopen/fullarticle/2685628

2National Institute on Drug Abuse. “Benzodiazepines and Opioids.” NIDA, 15 Mar. 2018, www.drugabuse.gov/drugs-abuse/opioids/benzodiazepines-opioids.

3Centers for Disease Control and Prevention (CDC). National Vital Statistics System, Mortality. CDC WONDER Online Database. https://wonder.cdc.gov/. Published 2017.