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Questions? Contact Customer Service at (855) 645-8448

The Drug Management Program

Memorial Hermann Health plan is committed to improving the health and wellness of our members and community. We are working together with your doctor, pharmacists and other healthcare professionals and partnering with our members in addressing the risks, dangers and use of prescription pain medications.

Prescription pain medications including opioids can help manage pain when used appropriately such as pain due to surgery or an injury but they also can be dangerous when misused or used inappropriately leading to serious risks of addiction, overdose or death. These risks can be increased when you get pain medications from multiple doctors or pharmacies and if you take other medications that can interact with your opioids such as Benzodiazepine – a class of medication that can be used to treat conditions like anxiety or seizures. Examples of a Benzodiazepine drugs include Alprazolam (Xanax®), Diazepam (Valium®), and Clonazepam (Klonopin®). Examples of opioid pain medications include Oxycodone (OxyContin®), Hydrocodone (Vicodin®), and Hydromorphone (Dilaudid®) to name a few.

Safety is our Priority

The goal of the DMP is to improve care coordination for safer use of benzodiazepines and opioid medications. All Medicare drug plans have a drug management program (DMP) to help patients who are at risk for prescription drug abuse. If you get opioids from multiple doctors or pharmacies, your plan may talk with your doctors to make sure you need these medications and that you’re using them safely.

Memorial Hermann Health Plan works with your pharmacists and doctors to do a safety review when you fill your prescriptions and to make sure you need these medications. If we identify that your prescription opioids and benzodiazepines are not safe or may pose a risk or danger to your health, then we may limit your coverage of these drugs under our drug management program and may require you to get these medications only from certain doctors or pharmacies to better coordinate your health care needs. Memorial Hermann Health Plan will notify you by letter if you will be affected by the drug management program. You and your doctor can also disagree and appeal any decision by the plan.

Exceptions to the DMP

The safety reviews and Drug Management Programs (DMP) generally won’t apply to you if you have active cancer, are in hospice care, have palliative care, or end-of-life care, or if you live in a long-term care facility. If you believe that you have any of the conditions listed, please call our Customer Service Department and inform the plan.

Talk to your Doctor

Talk with your doctor about all your pain treatment options, including whether taking an opioid medication is right for you. You might be able to take other medications or do other things to help manage your pain with less risk. What works best is different for each patient. Treatment decisions to start, stop or reduce prescription opioids should be made by you and your doctor. For more information on safe and effective pain management, visit CDC website.

Related Resources

You may also learn more about opioid medications, patient safety, requirements of the DMP, and resources to assist you with taking opioid pain medications and benzodiazepine safety by visiting the following websites or resources.

Additional Questions or Concerns

Do you have questions, concerns, need more information or documents? Call our Customer Service department at (855) 645-8448 (TTY 711) to learn more about how our Drug Management Program (DMP) program works. Hours of operation are 7 days a week from 8 a.m. to 8 p.m. CT, during October 1 – March 31 and Monday – Friday from 8 a.m. to 8 p.m. CT, during April 1 – September 30.

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