ForwardHealth Is Reinstating the Short-Acting Opioids Quantity Limit

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 reinstated a quantity limit of 360 units for short-acting opioids, which will remain in effect until February 28, 2026.

For dates of service (DOS) between December 1, 2025, and February 28, 2026:

• 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.

Effective March 1, 2026, short-acting opioids will be reduced from 360 units to 240 units. Providers were notified of this change December 19, 2025, through Update 2025-36, “January 2026 Preferred Drug List Changes and Other Pharmacy Policy.” Refer to Update 2025-36 for more information.

For DOS on and after March 1, 2026:

• All short-acting opioids will have a cumulative quantity limit of 240 units per month.
• Members will be limited to 240 units per month. When a claim is submitted with a quantity that exceeds the quantity limit, the claim will be denied.

The impacted drugs are listed on the Quantity Limit Drugs and Diabetic Supplies data table on the Pharmacy Resources page of the ForwardHealth Portal.