December 21, 2016
Long-acting opioids to require prior authorization effective 1/1/2017
Plans Affected:  Mercy Care Plan and Mercy Care Plan Long Term Care 
 
Effective 1/1/2017, AHCCCS is requiring prior authorization (PA) for ALL long acting opioids AND changes have been made to the preferred drug list in this category.
 
Preferred Drugs:
* Oxycontin
* Butrans Patch
* Morphine Sulf ER Tabs
* Fentanyl 12.5mcg, 25mcg, 50mcg, 75mcg, & 100mcg Patches
* Hysingla
* Embeda

Non-Preferred Drugs:
* Exalgo
* Oxymorphone ER
* Zohydro ER
* Xartemis XR
* Nucynta ER
* Methadone
* Belbuca
* Xtampza
* Tramadol ER
* Morphine Sulf ER Caps
* Kadian ER
* Conzip
* Hydromorphone ER
* Oxycodone ER
* Fentanyl 37.5mcg, 62.5mcg, & 87.5mcg Patches
* Duragesic Patches (all strengths)

Preferred Long-acting Opioids
  • Members on a preferred long-acting opioid that required prior authorization prior to 1/1/2017 will be maintained on current prior authorization cycle review.
  • Members on a preferred long-acting opioid that did not require prior authorization prior to 1/1/2017 will be grandfathered on current strength and quantity. Any change to current strength or quantity will require prior authorization.
Non-preferred Long-acting Opioids
  • Members on a non-preferred long-acting opioid that required prior authorization prior to 1/1/2017 will be maintained on current prior authorization cycle review.
  • Members on a non-preferred long-acting opioid that did not require prior authorization prior to 1/1/2017 will be grandfathered on current strength and quantity. Any change to current strength or quantity will require prior authorization. 
Additionally, all formulary changes are noted on the January formularies listed on our website .

Please contact your Provider Relations representative at 602-263-3000 or 800-624-3879 should you have any questions.
 
QB 2316