January 2019

New Morphine Dose Limitation Beginning this Month

Many health care groups, including those participating in Blue Cross and Blue Shield of Texas (BCBSTX) networks, have addressed their role in the opioid health crisis. Data shows more than 115 Americans are dying each day from an opioid overdose. Additionally, opioid prescriptions continue to contribute to the epidemic in the U.S.

To promote safe and effective opioid prescription use by our members, beginning Jan. 28, 2019, BCBSTX Medicaid plans will decrease the daily morphine milligram equivalents (MME) limit (formerly the morphine equivalent dose) for members with STAR, STAR Kids and CHIP prescription drug coverage.

Maximum Allowable Limit
The new maximum allowable limit will be 90 MME and applies to all opioid prescriptions. Exceptions are for people diagnosed with cancer, or those who receive palliative or hospice care. (Additional clinical issues may be considered). This will be the final maximum allowable limit decrease.

Providers should access, complete and submit the STAR/CHIP or STAR Kids prior authorization forms via fax to 1-877-243-6930, or call 1-855-457-0407 (STAR and CHIP) or 1-855-457-1200 (STAR Kids).

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