In a final rule published August 16 in the Federal Register, the Center for Medicare and Medicaid Services said that information did not need to be collected on patients on methadone or buprenorphine receiving benzodiazepines as part of palliative care. (It also said it didn’t need to include cancer care.)
“Some commenters recommended excluding patients receiving medication for the treatment of opioid use disorder (OUD). A few commenters specifically recommended that the measure exclude patients being treated with buprenorphine or methadone for OUD, with a commenter citing guidance from the U.S. Food & Drug Administration regarding buprenorphine.”
CMS: “We recognize that there may be some clinically necessary situations for concurrent prescriptions of opioids and benzodiazepines, and we agree with the need to properly treat these patients. Regarding the commenter’s concern that the measure’s exclusion for palliative care does not fully capture terminally ill patients, we note that patients with an order for palliative care during the encounter are excluded from the denominator, which includes comfort measures, terminal care, dying care, and hospice care, and that these exclusions align with the populations excluded from the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain.”
But in the future, CMS may take this into consideration, particularly for patients treated with MAT for OUD.
