Due to a systems issue, the intended quantity limit of 240 units for short-acting opioids that was announced in ForwardHealth Update 2024-52, “January 2025 Preferred Drug List Changes and Other Pharmacy Policy Changes,” did not go into effect on March 1, 2025. As a result, ForwardHealth is reinstating a quantity limit of 360 units for short-acting opioids effective for dates of service (DOS) on and after December 1, 2025. The impacted drugs are listed on the Quantity Limit Drugs and Diabetic Supplies data table on the Pharmacy Resources page of the ForwardHealth Portal. For DOS on and after December 1, 2025, all short-acting opioids will have a cumulative quantity limit of 360 units per month. Members will be limited to 360 units per month. ForwardHealth will deny claims that exceed the quantity limit. Providers will be notified through a separate communication when the quantity limit reduction for short-acting opioids, from 360 units to 240, will be reinstated.
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