Alabama's opioid prescription rates have fallen in recent years as awareness of appropriate opioid use and the dangers of misuse have grown. Alabama has dropped from first in the nation for the number of opioid prescriptions to second. 

To combat the opioid epidemic in Alabama, we launched an opioid management strategy in 2022. This strategy was created with guidance from the CDC’s “Guidelines for Prescribing Opioids for Chronic Pain” publication. Blue Cross members who have cancer or are currently receiving opioids will not be subject to the guidelines below, which are designed to decrease misuse of opioid prescriptions.

Guidelines

• Members are required to obtain prior authorization for all first-time prescriptions for long-acting opioid medications, including OxyContin and MS Contin.
• Naloxone, the antidote for an opioid overdose, is available to most members for the generic copayment. This includes both the prefilled syringes and nasal spray. 

For more information on these guidelines, see “Opioids ER Prior Authorization and Quantity Limit Criteria Program Summary” our pharmacy policies. Here is the updated emergency room policy link: Policies & Guidelines. 

Pain Medication and Care Improvement Program

We have partnered with axialHealthcare^®, a national leader in pain management and pain medication solutions, to provide a Pain Medication and Care Improvement Program. Together, we are collaborating with Alabama physicians to continue reducing the epidemic of opioid misuse. This partnership supports providers by:

• Offering a more comprehensive view of a patient’s medical history.
• Providing ongoing consultation with axialHealthcare’s team of advanced practice providers, clinical pharmacists, nurses, medical assistants and engagement specialists.
• Increasing awareness of prescribing behaviors and the latest evidence-based guidelines.
• Sharing resources and educational tools to support appropriate prescribing protocols.

Clinical and engagement specialists from axialHealthcare will contact Alabama providers to offer pain management/medication consultative services to help reduce opioid misuse. 

Opioid Pain Management Tool

The Opioid Pain Management Tool provides advanced analytics regarding your prescribing patterns and your patients’ opioid prescription history. The data is based exclusively on Blue Cross and Blue Shield of Alabama claims data for most, but not all, Blue Cross members. Data in the tool is updated monthly.

Access the “Opioid Pain Management Tool” by selecting from the ProviderAccess Profiles & Reports menu. View our Opioid Pain Management Tool Overview flier for more information.

The Opioid Reduction Tool, which is part of the Opioid Pain Management tool is available to help providers reduce or remove opioid use for their patients. Review this guide for using the Opioid Reduction Tool.

Blue Cross determines qualification for incentive programs based on the Opioid Pain Management Tool Risk Identification Mitigation (RIM) score.

 
An independent company, axialHealthcare provides pain care analytics and evidence-based solutions for physicians and advanced practice providers in the Blue Cross and Blue Shield of Alabama network.