Medicare AdvantageDocumentationMedium impact
[Ohio] Medication safety alerts: reducing opioid and anticholinergic risk
Anthem BCBS·OH · Geriatrics, Internal Medicine, Family Medicine +3 more·Provider Bulletin
Effective date
Jun 30, 2026
We identified it
Jul 1, 2026
Summary
Anthem Blue Cross and Blue Shield (Ohio) issued a medication safety alert focused on reducing opioid and anticholinergic risks for Medicare Advantage members. The policy emphasizes CMS Part D Star Measures requiring providers to identify and manage high-risk medication combinations: opioid + benzodiazepine overlap (COB) in adults ≥18 and multiple anticholinergics (Poly-ACH) in adults ≥65. Billing teams must ensure clinical documentation supports medication safety interventions and deprescribing efforts to align with quality metrics.
Action Required
Effective immediately (June 30, 2026): (1) Providers and billing staff must integrate medication reconciliation and high-risk combination screening into encounter documentation workflows. (2) Ensure EHR systems flag opioid + benzodiazepine overlaps (≥30 cumulative days in adults ≥18) and multiple anticholinergic use (≥2 concurrent medications ≥30 cumulative days in adults ≥65). (3) Document all deprescribing efforts, tapering plans, and clinical rationale for retained medications on patient records to support Star Ratings measures. (4) Billing team must verify claims include supporting documentation for any medication management visits or clinical interventions related to these high-risk combinations. (5) Providers should complete the offered webinar on Polypharmacy: Medication Safety in Older Adults (available 24/7) to ensure consistent application. Failure to document safety interventions may result in reduced Star Ratings performance scores affecting plan quality metrics and potential reimbursement adjustments for participating Medicare Advantage plans.