MedicaidCoverageHigh impact
Opioid Days Supply (Revised)
Humana·LA·Medicaid
Effective date
Oct 1, 2025
We identified it
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.
Action Required
By October 1, 2025: Update billing system to flag opioid prescriptions exceeding 7 days for opioid-naïve patients and 30 days for opioid-tolerant patients. Providers must document qualifying diagnoses (cancer, sickle cell disease, palliative care, 2nd/3rd degree burns) to override limits. Claims coordinator should verify opioid tolerance history (90+ days within past 120 days) before processing longer supplies. Failed compliance will result in quantity limit denials.