Medicare AdvantageDocumentationMedium impact
[Virginia] Medication safety alerts: reducing opioid and anticholinergic risk
Anthem BCBS·VA · Geriatrics, Internal Medicine, Family Medicine +3 more·Provider Bulletin
Effective date
Jun 30, 2026
We identified it
Jul 1, 2026
Summary
Anthem Blue Cross has issued a medication safety alert for Medicare Advantage plans in Virginia focusing on reducing opioid and anticholinergic risks. The policy highlights two high-risk medication combinations—opioid/benzodiazepine overlap and multiple anticholinergics in older adults—that align with CMS Part D Star Measures. Providers must implement medication reconciliation, deprescribing protocols, and use of PDMP checks to reduce overdose and fall-related harm.
Action Required
By July 15, 2026: Providers and clinical staff must implement medication safety protocols for all Medicare Advantage patients in Virginia. (1) Update EHR systems to flag high-risk medication combinations—specifically opioid + benzodiazepine overlaps ≥30 cumulative days and multiple anticholinergics ≥30 cumulative days in patients ≥65. (2) Establish mandatory medication reconciliation at every visit, including OTC and supplements, with documentation in the chart. (3) Train providers to use PDMP before prescribing opioids and to consider naloxone for at-risk patients. (4) Create a deprescribing checklist for clinicians to review at refills—ask if medication is still needed and develop patient-centered tapering plans. (5) Review all current patient medications to identify those meeting these high-risk criteria and begin interventions. Billing team must ensure claims reflect appropriate medication management documentation; claims may face quality measure audits if medication safety protocols are not documented. Failure to implement these practices may negatively impact Star Ratings performance and quality measure compliance for this Medicare Advantage plan.