New Concurrent Opioid and Benzodiazepine Prior Authorization Program for Blue Cross Community CentennialSM Members
Recent data shows that more than 115 Americans die each day from an opioid overdose,1 and more than 30 percent of opioid overdose events involve the use of opioids and benzodiazepines taken at the same time.2
Using these drugs together can cause increased sedation and respiratory depression, which are common effects of both medicines.2 Long-term use of these medicines at the same time also drastically raises the chance of an opioid-linked overdose.3
To support safe and effective opioid prescription use by our members, effective Jan. 2, 2019, Blue Cross and Blue Shield of New Mexico (BCBSNM) will require prior authorization approval for concurrent opioid and benzodiazepine prescriptions for members with Blue Cross Community Centennial prescription drug coverage. Blue Cross Community Centennial members filling concurrent or overlapping opioid and benzodiazepine prescriptions without this prior authorization will be denied at the pharmacy as part of our ongoing efforts to enhance patient safety.
Providers can access, complete and submit the prior authorization form electronically from the CoverMyMeds.com login page, the Prime Therapeutics® website MyPrime.com , via fax to 877-480-8130, or over the phone at 866-202-3474.
Members and providers can call the Member Services number on the member’s ID card for any questions about this change.
- Hernandez, Inmaculada, et al. “Association Between Concurrent Opioid-Benzodiazepine Use and Risk of Opioid-Related Overdose.” JAMA, American Medical Association, 22 June 2018, jamanetwork.com/journals/jamanetworkopen/fullarticle/2685628
- National Institute on Drug Abuse. “Benzodiazepines and Opioids.” NIDA, 15 Mar. 2018, www.drugabuse.gov/drugs-abuse/opioids/benzodiazepines-opioids .
- Centers for Disease Control and Prevention (CDC). National Vital Statistics System, Mortality. CDC WONDER Online Database. https://wonder.cdc.gov/ . Published 2017.
Blue Cross and Blue Shield of New Mexico (BCBSNM) contracts with Prime Therapeutics to provide pharmacy benefit management and related other services. In addition, contracting pharmacies are contracted through Prime Therapeutics. The relationship between BCBSNM and contracting pharmacies is that of independent contractors. BCBSNM, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics.
Please note that verification of eligibility and benefits, and/or the fact that a service or treatment has been prior authorized or predetermined for benefits is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. If you have questions, contact the number on the member’s ID card.