CMS released a bulletin last week warning providers that the rescheduling of hydrocodone combination drugs could increase the cost of settlements, mainly due to the new, more restrictive prescribing practices and subsequent increased visits to the prescribing doctor. CMS explains: “Normally, [Schedule III drugs or C-IIIs] required a new prescription after five refills or after six months, whichever occurs first. [Schedule II drugs or C-IIs] require new prescriptions at intervals no greater than 30 days; however, a practitioner may issue up to three consecutive prescriptions in one visit authorizing the patient to receive a total of up to a 90 day supply of a C-II.” Hydrocodone combination products are now Schedule II drugs. For this reason, CMS announced that Medicare WCMSA guidelines will change on January 1, 2015 for all new cases submitted after that date to, at a minimum, allocate 4 healthcare provider visits per year when Schedule II controlled substances are used continuously unless healthcare provider visits are more frequent per medical documentation.
Read the full bulletin from CMS here.