SUPPORT Act Compliance Clause Samples
SUPPORT Act Compliance. In accordance with the federal Substance Use Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, the Contractor shall implement and maintain the following processes and standards by October 1, 2019:
1. Safety edits and claims review automated process for the State-approved maximum daily morphine limitation
2. Safety edits and claims review automated process for the State-approved maximum daily morphine equivalent for treatment of chronic pain
3. Claims review automated process that monitors when a client is concurrently prescribed opioids and benzodiazepines, or is concurrently prescribed opioids and antipsychotics
4. Program to monitor and manage the appropriate use of antipsychotic medications by Medicaid children
5. Process that identifies potential fraud or abuse of controlled substances by Medicaid clients, enrolled prescribers, and enrolled dispensing pharmacies
SUPPORT Act Compliance. In accordance with the federal Substance Use Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act and section 1902(a)(85) of the Social Security Act, the Contractor shall implement and maintain the following processes and standards:
1. Safety edits and claims review automated process for the State-approved maximum daily morphine limitation
2. Prospective safety edits on subsequent fills of opioid prescriptions, as specified by the State, which may include edits to address days’ supply, early refills, duplicate fills and quantity limitations for clinical appropriateness
3. Prospective safety edits and claims review automated process for the State- approved maximum daily morphine equivalent on opioids prescriptions
4. Retrospective reviews on opioid prescriptions exceeding above limitation on an ongoing basis
5. Claims review automated process that monitors when a client is concurrently prescribed opioids and benzodiazepines, or is concurrently prescribed opioids and antipsychotics on an ongoing basis
6. Program to monitor and manage the appropriate use of antipsychotic medications by Medicaid children
7. Process that identifies potential fraud or abuse of controlled substances by Medicaid clients, enrolled prescribers, and enrolled dispensing pharmacies
8. Review of antipsychotic agents for appropriateness for all children eighteen (18) and under, including ▇▇▇▇▇▇ children based on approved indications and clinical guidelines
SUPPORT Act Compliance. In accordance with the federal Substance Use Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act and Section 1902(a)(85) of the Social Security Act, the Contractor shall implement and maintain the following processes and standards:
1. Safety edits and claims review automated process for the State-approved maximum daily morphine limitation
2. Prospective safety edits on subsequent fills of opioid prescriptions, as specified by the State, which may include edits to address days’ supply, early refills, duplicate fills , and quantity limitations for clinical appropriateness
3. Prospective safety edits and claims review automated process for the State-approved maximum daily morphine equivalent on opioids prescriptions
SUPPORT Act Compliance. In accordance with the federal Substance Use Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act and section 1902(a)(85) of the Social Security Act, the Contractor shall implement and maintain the following processes and standards:
1. Safety edits and claims review automated process for the State-approved maximum daily morphine limitation
2. Prospective safety edits on subsequent fills of opioid prescriptions, as specified by the State, which may include edits to address days’ supply, early refills, duplicate fills, and quantity limitations for clinical appropriateness
3. Prospective safety edits and claims review automated process for the State- approved maximum daily morphine equivalent on opioid prescriptions
4. Retrospective reviews on opioid prescriptions exceeding above limitation on an ongoing basis
5. Claims review automated process that monitors when a client is concurrently prescribed opioids and benzodiazepines, or is concurrently prescribed opioids and antipsychotics on an ongoing basis
SUPPORT Act Compliance. In accordance with the federal Substance Use Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act and Section 1902(a)(85) of the Social Security Act, the Contractor shall implement and maintain the following processes and standards:
SUPPORT Act Compliance. In accordance with the federal Substance Use Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, the Contractor shall implement and maintain the following processes and standards:
1. Safety edits and claims review automated process for the State-approved maximum daily morphine limitation
2. Safety edits and claims review automated process for the State-approved maximum daily morphine equivalent for treatment of chronic pain
3. Claims review automated process that monitors when a client is concurrently prescribed opioids and benzodiazepines, or is concurrently prescribed opioids and antipsychotics
SUPPORT Act Compliance. The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) Act, requires that behavioral health services, including mental health treatment, substance use disorder treatment, and interventions for developmental delays be made available to Children’s Health Insurance Program (CHIP). In accordance with section 5022(d) of the Act, the PIHP must assure that age appropriate, validated screening tools are used to identify behavioral health needs for individuals ages 0-18 in primary care settings. Validated screening tools for children can be found at ▇▇▇▇▇://▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇/star- center/#/screening-tools and ▇▇▇▇▇://▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇/BrowseRec/Index. The PIHP must assure that screenings are conducted according to the most recently published AAP/Bright Futures periodicity schedule: ▇▇▇▇▇://▇▇▇▇▇▇▇▇▇.▇▇▇.▇▇▇/AAP/PDF/periodicity_schedule.pdf. On an annual basis, the PIHP must report to the Department the specific tools and/or protocols used by their primary care providers when screening children for the following behavioral health areas:
a. General development;
b. Autism spectrum disorder;
c. Tobacco, alcohol or drug use;
d. Depression;
e. Any additional areas/tools. This report must be submitted to the PIHP’s DHS contract administrator , Attn: Behavioral Health Policy Section in Excel format by July 1st of each calendar year.