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Opioid Days' Supply Limitation (Revised)
Act
by Jan 1, 2025
Effective date
Jan 1, 2025
Identified
Jun 24, 2026
Summary
Humana Medicaid Oklahoma has revised their opioid prescribing limits, restricting opioid-naive patients to a maximum 7-day supply for initial acute pain treatment, while opioid-tolerant patients can receive up to 30 days for non-acute pain. The policy includes specific exemptions for cancer, sickle-cell disease, palliative care, and long-term care facility residents.
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What to do
by Jan 1, 2025 · 3 steps
01Billing team must update pharmacy billing systems to enforce quantity limits on opioid prescriptions for Oklahoma Medicaid patients.
02Providers must document opioid-naive status (no opioid therapy in past 108 days) and limit initial prescriptions to 7-day supplies unless patient meets exemption criteria (cancer, sickle-cell disease, palliative care, long-term care facility resident, or opioid-tolerant).
03Update encounter forms to include opioid history screening and exemption checkboxes to prevent claim denials for excess quantities.
Original notice
Opioid Days' Supply Limitation (Revised)
mcp.humana.com · Always check the source before changing claims.