● Prior Auth General· 5h ago · PA coordinator · TXDiscussion

Cigna is now PA-ing Tier 1 opioids — safety edits even at the lowest tier. Anyone else?

Seeing hard stops on IR formulations that used to sail through. Looks like a morphine-equivalent edit. Curious if this is national or just our book.

▲ 22💬 2 commentsby pa-coord-tx
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rx-manager-oh · Pharmacy · OH · 3h ago

Same here — IR oxycodone hard-stopping under Cigna commercial. We started attaching the PDMP printout up front and it clears about half of them.

5
appeals-rn · Appeals RN · 2h ago

It's a morphine-equivalent (MED) edit, not a formulary PA. If you're under 90 MED it usually auto-approves with the diagnosis on the claim.

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