In 2018, Walmart (including Sam’s Club) and CVS Caremark implemented dosage and duration corporate policies to restrict opioid prescriptions filled at their pharmacies. Specifically:

  • Walmart restricted initial opioid prescriptions for acute pain to no more than seven days and 50 morphine milligram equivalents (MME)
  • CVS Caremark restricted initial opioid prescriptions for an acute condition to a seven-day supply and 90 MME, although prescribers may request a prior authorization for higher doses up to 200 MME/day 

Physicians have also reported being asked for extensive medical documentation such as treatment agreements, tried/failed therapies, and diagnoses codes before an opioid prescription will be filled by the pharmacist. CMA is concerned that the effects of these new corporate policies may intrude upon the physician-patient relationship, compromise patient confidentiality, and create barriers for patients who need access to their medications. CMA is monitoring this situation to assess the impact upon patient care. If you or your patients have encountered such policies, please contact CMA's Center for Legal Affairs at 1-800-786-4262 or legalinfo@cmadocs.org.