Our goal is to ensure that all members have access to appropriate care and pain management through our programs, medication policies and guidelines. We help detect and prevent inappropriate medication use while encouraging and helping you manage and support appropriate opioid use for pain management. Verify patient benefits and eligibility on the Availity Provider Portal.
- Extended-release (ER) Opioid Medication Products for Pain, medication policy (dru515)
- Immediate-release (IR) Opioid Medication Products for Pain, medication policy (dru516)
- Urine Drug Testing for Substance Abuse and Chronic Pain, medical policy (Laboratory #68)
- Clinical Practice Guideline - Management of Chronic Noncancer Pain with Opioids in Adults
- Clinical Practice Guideline - Screening and Management of Substance Use Disorder in Adults
- Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain
- 2019 Medicare Part D Opioid Policies: Information for Prescribers (PDF)
- MLN Matters - A Prescriber's Guide to the New Medicare Part D Opioid Overutilization Policies for 2019 (PDF)
Tools and resources
- Care Management program
- Personalized Care Support program
- Physical Medicine program, including interventional pain management
If you have suggestions or questions about this toolkit, please email us. Together, we can help our members – your patients – get and stay well.