Opioid Refill Threshold Increase


TO:     ALL Providers

Effective November 26, 2018, Alabama Medicaid will increase the refill tolerance threshold for both agonist and partial agonist opioids from 75% to 85% of the original days’ supply. This applies to all outpatient pharmacy claims for opioids.


The refill tolerance thresholds for all other drugs will remain the same: for quantities equal to or less than a 34-day supply, the refill tolerance threshold will remain at 75% of the original day’s supply.  For quantities greater than a 34-day supply, the designated amount is 90% of the original days’ supply.


Policy questions related to this provider notice should be directed to the Pharmacy Clinical Services Program at 334-242-5050.

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