{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:06:24Z","timestamp":1786975584609,"version":"build-2736575974"},"reference-count":40,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"\n Importance<\/jats:title>\n Medicare beneficiaries with disabilities have excess opioid-related morbidity and mortality. A 2019 Medicare opioid safety policy was designed to address high-risk opioid prescribing and related harms by limiting the initial duration to 7 days and restricting high daily dosage across multiple prescribers.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the association of the 2019 Medicare opioid 7-day and 90\u2212morphine milligram equivalence (MME) safety edits with opioid use among beneficiaries with disabilities.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This interrupted time-series study used claims data from Optum\u2019s deidentified Clinformatics Data Mart database to assess changes in opioid prescriptions and use among Medicare Advantage beneficiaries (younger than 65 years) with disability entitlements from June 2016 to September 2021. The analysis compared opioid use outcomes before and after the safety policy was implemented in 2019 (including the COVID-19 pandemic) in 2 cohorts of patients (new to opioids vs long-term opioid use). Data analyses were performed from September 2023 to October 2024.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Implementation of the Medicare opioid 7-day and 90-MME safety edits in January 2019.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Likelihood of an initial opioid prescription more than 7 days\u2019 supply and 30-day total MME; likelihood of development of long-term opioid use in a new-to-opioid cohort; the number of concurrent multiple-prescriber high-dosage episodes in a long-term opioid cohort.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The new-to-opioids cohort included 476\u202f859 person\u2212index months (mean [SD] age, 55.7 [7.8] years; 281\u202f536 [59.0%] women). The long-term opioid cohort included 3\u202f295\u202f299 person\u2212index months (mean [SD] age, 56.3 years [6.6]; 1 887 547 [57.3%] men and 1\u202f407\u202f752 [42.7%] women). The 7-day safety edit was associated with immediate and sustained reductions in the likelihood of an initial opioid prescription filled for more than 7 days\u2019 supply (start of the post-policy period: 46.7 % reduction; 99.5% CI, \u221248.3% to \u221245.2%; end of study period: 43.8% reduction; 99.5% CI, \u221245.7% to \u221241.9%). In contrast, moderate immediate reductions in the likelihood of development into long-term opioid use (13.8% reduction; 99.5% CI, \u221220.5% to \u22127.2%) diminished by the end of the study period (4.0% reduction; 99.5% CI, \u221210.4% to 2.4%). The 90-MME safety edit was associated with an immediate 36.1% reduction (99.5% CI, \u221242.8% to \u221229.4%) in the number of concurrent multiple-prescriber high-dosage episodes, which was reversed when the COVID-19 flexibility rolled back the 90-MME edit.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The findings of this interrupted time-series study of Medicare Advantage beneficiaries younger than 65 years with disabilities show that the 2019 Medicare opioid safety policy was associated with shorter initial duration of opioid prescriptions and fewer concurrent multiple prescriber high-dosage prescriptions of opioids. Given that downstream reductions appeared to be transient, further interventions are needed to address the clinical and social risk factors for opioid misuse among beneficiaries with disabilities.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamainternmed.2024.7810","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T11:01:40Z","timestamp":1739185300000},"page":"422","source":"Crossref","is-referenced-by-count":3,"title":["Medicare Opioid Policy and Opioid Use in Beneficiaries With Disabilities"],"prefix":"10.1001","volume":"185","author":[{"given":"Hefei","family":"Wen","sequence":"first","affiliation":[{"name":"Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Halbisen","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Pilgrim 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Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marguerite E.","family":"Burns","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenton J.","family":"Johnston","sequence":"additional","affiliation":[{"name":"Department of Medicine, Washington University School of Medicine, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryant","family":"Shuey","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Franklin","family":"Wharam","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke University School of Medicine, 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