Back to Insights and Updates for ProvidersAugust 2023

Reminder: Prior authorization for long-acting opioids

Harvard Pilgrim Health Care Commercial  |  Tufts Health Direct  |  Tufts Health Plan Commercial

Harvard Pilgrim Health Care commercial, Tufts Health Plan commercial, and Tufts Health Direct require prior authorization for select long-acting opioids.

As we noted in the Dec. 2022 newsletter, prior authorization for long-acting opioids took effect for Harvard Pilgrim commercial members initiating a new course of treatment on or after Jan. 1, 2023, and members who were already taking a long-acting opioid would require authorization at a later date.

As a reminder, Harvard Pilgrim commercial members who are currently taking a long-acting opioid and who have not had a clinical review completed will require authorization on or after Nov. 1, 2023.

For more information, please refer to the Pharmacy Medical Necessity Guidelines for Opioid Analgesics.

Audrey Kleinberg,
Director, Provider Relations & Communications

Annmarie Dadoly,
Senior Manager, Provider Communications

Joseph O’Riordan, Susan Panos, Stephen Wong,

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Production Coordinator

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Graphic Designer