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CDC Opioid Guidelines
Day #1
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One patient’s formulary changed with Blue Shield of CA and the ONLY opioid now available to her without a prior authorization is rectal suppository morphine.
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I almost choked on my wheatberries on this one.
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— addicts would love them. Patients, not so much.
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Be warned people.
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Is that 6 suppositories every 3 hours?
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Pain Management Specialist in San Diego & La Jolla 
03/16/2016 at 9:25 pm
The insurance companies are laughing at us as they write these rules. Laughing at the people who have made them richer than entire nations. Companies where there isn’t a single patient or medical professional advocate present during the meetings where decisions such as rectal suppositories as the only covered option are made. My insurance (UHC) will cover opioids for now for my condition , but will not cover less or non-habit forming drugs like Celebrex or any of it’s generics, forcing patients to keep taking stomach shredding Naproxen and liver destroying meds like acetaminophen. They require monthly visits to the pain specialist who must conduct full drug screening (2 years of monthly screenings and never had a problem), a full exam, liver function screening, and the 50 minute drive each way for the patient followed by a 30 minute to 3 hour wait in the waiting room. I’m not supposed to sit or stand continuously for more than 10 minutes. It takes about 3-6 days to recover from these trips. The funniest thing is, the drug screening costs UHC $1150 per test, another $270 for the office visit, $70 for the blood work, plus the six meds I have to take to deal with the stomach and/or liver issues. In other words, they are spending a dollar to save a penny. The joke will be on them when my liver fails and I either get a transplant, or they get sued (every denial of coverage, every mistake in billing, every negligent decision has been documented and explained in writing. So far my pain management doc is willing to put in all the extra effort to prove the patient requires the narcotic painkillers. I would rather take less and not feel nearly the severity like if I could take Celebrex which works extremely well for me. My doctor has written 3 times to get the drug covered n my case, even showing all the costs they could save by approving it. No, no is the response each time. I don’t know how many more hours of extra hoop jumping my doc is willing to do.
J.