New Part D Measures Supporting Safe Medication Use
As part of our commitment to supporting safe and effective medication use for our Medicare members, we want to make you aware of two new CMS-approved Part D pharmacy measures. These measures focus on reducing high-risk medication combinations and improving outcomes for older adults. The full
Provider Notification Process
To support your practice, we are conducting proactive outreach when a patient meets criteria for one of these measures.
- Fax notifications are sent to provider offices when a member is identified.
- Follow‑up phone outreach is conducted after the fax to ensure awareness and offer support.
We share this so your teams can anticipate these communications and understand their purpose.
Concurrent Use of Opioids and Benzodiazepines (COB)
This measure assesses the percentage of Medicare Part D beneficiaries 18 and older with 30 or more cumulative days of overlapping prescriptions for opioid and benzodiazepine prescriptions within the calendar year.
The Centers for Disease Control and Prevention (CDC) recommends avoiding concurrent use whenever possible due to the increased risk of additive sedation and respiratory depression, which increases the risk of fatal overdose.
Source: Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. MMWR Recomm Rep 2022;71(No. RR‑3):1–95.
Key Actions for CMS Measure Compliance
- Review medication profiles for overlapping therapy
- Evaluate alternative treatment options when clinically appropriate
- Limit dose or duration when coprescribing is necessary
- Gradual tapering long-term therapy when feasible
Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (POLYACH)
This measure captures the percentage of Medicare Part D beneficiaries 65 and older who receive two or more unique anticholinergic medications concurrently for 30 cumulative days or more. Concurrent use increases the risk of falls, cognitive impairment, and other adverse outcomes.
Key Actions for CMS Measure Compliance
- Review the medication list regularly to assess deprescribing opportunities
- Select alternatives with a lower anticholinergic burden when possible
- Educate patients and caregivers about potential side effects
We’re Here to Partner with You
Our pharmacy and clinical teams are available to collaborate with you on these measures and to review medication patterns for your patients as needed. We value your clinical expertise and appreciate your partnership in promoting safe medication use and improving outcomes for Medicare patients.