Massachusetts Blue Cross Blue Shield Initiates Pre-authorization for Painkillers to Control Drug Abuse

Pre-authorization for therapeutic drugs is one step on the path to payers requiring similar pre-authorization for expensive clinical laboratory tests

It’s a step on the road to pre-authorization for both certain therapeutic drugs and expensive genetic tests. Blue Cross Blue Shield of Massachusetts (BCBSMA) recently announced that it would work to curb drug abuse through a new pre-authorization program for certain prescription drugs.

Clinical laboratory managers and pathologists should take this as a sign that managed care plans are increasingly willing to tackle issues associated with unnecessary utilization by implementing pre-authorization requirements, among other strategies.

At the top of the pre-authorization list for BCBMSA will be such drugs as Oxcycontin, Percocet, and Vicodin. In recent years, the medical laboratory industry has watched the increase of pain management testing by physicians who treat patients taking these types of addictive drugs. (more…)