All PlansPrior AuthHigh impact
Opioids and safeguards to help protect older adults
Cigna·Pain Management, Family Medicine, Internal Medicine +4 more·Pharmacy
Effective date
Apr 1, 2024
We identified it
Jun 19, 2026
Summary
Cigna Healthcare has updated their opioid safety protocols with enhanced safeguards for patients 65 and older, implementing stricter utilization management including 7-day supply limits for opioid-naive patients, morphine milligram equivalent (MME) thresholds, and mandatory prior authorization requirements. The policy emphasizes point-of-sale safety edits and concurrent drug utilization reviews to prevent dangerous opioid-benzodiazepine combinations.
Action Required
By April 1, 2024: Billing team must ensure all opioid prescriptions for patients 65+ comply with new safety protocols. Update prior authorization workflows for opioid medications. Verify 7-day supply limits are enforced for opioid-naive patients in billing system. Train staff on MME threshold requirements and concurrent opioid-benzodiazepine restrictions. Access updated resources at CignaforHCP.com under Pharmacy Resources > Opioid Resources.