OLYMPIA – Opioid use disorder (misuse and addic­tion) is a national public health crisis. More than 90 Ameri­cans die every day from an opioid overdose. Studies show that patients are often prescribed more opioids than they need, and the risk of moving to chronic use rises dramat­i­cally with longer initial prescriptions.

As part of Washington State’s strategy to combat this crisis, starting Jan. 2, 2018, the Health Care Authority (HCA) will imple­ment an opioid clinical policy for Uniform Medical Plan (UMP). HCA manages prescrip­tions for UMP, the state’s self-insured Public Employees Benefits Board (PEBB) Program medical plan. 

HCA’s opioid clinical policy for UMP will limit the number of opioids that UMP will cover. The policy is a direct response to Governor Jay Inslee’s execu­tive order to combat the opioid crisis. By promoting safe prescribing practice, the policy is a tool to prevent misuse and addic­tion. Gov. Inslee last week issued his supple­mental budget proposal, which included additional funding for the state to combat opioid addiction. 

The policy sets the following limits: 

  • For people ages 20 or younger: 18 pills or 90 ml of liquid per prescrip­tion (about a three-day supply) 
  • For people ages 21 or older: 42 pills or 210 ml of liquid per prescrip­tion (about a week’s supply) 

The policy does not apply to UMP members who are: 

  • Already receiving ongoing opioid therapy. 
  • Receiving cancer treatment. 
  • In hospice care, pallia­tive care, or end-of-life care. 

The policy aligns with the prescribing guide­line from the Washington State Agency Medical Direc­tors Group and the Centers for Disease Control and Preven­tion opioid guidelines. 

In addition to an opioid clinical policy for UMP, HCA also imple­mented an opioid clinical policy for Apple Health (Medicaid). That policy took effect Nov. 1, 2017. 

Learn more about HCA’s opioid clinical policy for UMP and the opioid crisis #

Media contacts #

Amy Blondin, Chief Commu­ni­ca­tions Officer, 360 – 725-1915 

About Washington State Health Care Authority #

HCA oversees the state’s top two health care purchasers — Washington Apple Health (Medicaid) and the Public Employee Benefits Board Program. We work with partners to help ensure Washing­to­nians have access to better health and better care at a lower cost. For more infor­ma­tion, visit www​.hca​.wa​.gov.