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HumanaMedicaid · Coverage · Medicaid · LAHigh impact

Opioid Days Supply (Revised)

Act
by Oct 1, 2025
Effective date
Oct 1, 2025
Identified
Jun 24, 2026

Summary

Humana Medicaid Louisiana has updated their opioid days supply policy, limiting opioid-naïve patients to 7 days supply for acute pain and opioid-tolerant patients to 30 days supply for non-acute pain. Exceptions exist for cancer, sickle cell disease, palliative care, and severe burns.

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What to do

by Oct 1, 2025 · 4 steps
01Update billing system to flag opioid prescriptions exceeding 7 days for opioid-naïve patients and 30 days for opioid-tolerant patients.
02Providers must document qualifying diagnoses (cancer, sickle cell disease, palliative care, 2nd/3rd degree burns) to override limits.
03Claims coordinator should verify opioid tolerance history (90+ days within past 120 days) before processing longer supplies.
04Failed compliance will result in quantity limit denials.

Original notice

Opioid Days Supply (Revised)
mcp.humana.com · Always check the source before changing claims.
View original ↗

Related changes

See all Humana changes →
Opioid Days Supply (Revised)MediumEffective Oct 1, 2025 · MedicaidOpioid Days' Supply Limitation (Revised)HighEffective Oct 30, 2024 · Medicare AdvantageLimited Day Supply (Revised)HighEffective Oct 1, 2025 · MedicaidLimited Day Supply (New)HighEffective Oct 1, 2025 · MedicaidBrowse every Humana change in the policy list

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