Pharmacy Question for the Week of April 6, 2020

Question:

What is a lock-in program?

Answer:

According to the white paper, “Healthcare Payer Strategies to Reduce the Harms of Opioids”:

“One strategy that has arisen from drug utilization reviews is the effective use of a lock-in approach to ensure that prescriptions are based on an informed view of the patient. Under a lock-in program, a patient chooses a single provider, a single pharmacy, or both. Payers only impose lock-in after less restrictive steps have been attempted that have been ineffective in curbing “doctor shopping” or the use of multiple, over-lapping prescriptions. Medicaid agencies in forty-eight states and the District of Columbia report having lock-in programs. These programs are intended to improve care coordination between providers and decrease diversion costs.(174) The program design of lock-in programs vary across states with respect to how to determine that patients are “locked-in,” the length of the program, and the restrictions of the program.”

Print Friendly, PDF & Email
Facebook
Twitter
LinkedIn

CPT® copyright 2023 American Medical Association (AMA). All rights reserved.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.

Happy World Health Day! Our exclusive webcast, ‘2024 SDoH Update: Navigating Coding and Screening Assessment,’  is just $99 for a limited time! Use code WorldHealth24 at checkout.

SPRING INTO SAVINGS! Get 21% OFF during our exclusive two-day sale starting 3/21/2024. Use SPRING24 at checkout to claim this offer. Click here to learn more →