Provider Pharmacy Resources

True Health New Mexico members are subject to the CVS/Caremark Opioid Management program. This program limits the dose/quantity of opioids that members can receive. If a member exceeds the limitations, prior authorization is required.

In general, prior authorization can be satisfied by providing a copy of the member’s current treatment plan, a risk assessment evaluation, and a copy of the member’s opioid contract. Prescribers may also attest to use of these specific tools.

Prescribers should fax prior authorization requests for opioids to True Health New Mexico Pharmacy Services at 1-866-718-7938.

Below are several resources to help True Health New Mexico providers manage their patients who are taking opioids. True Health New Mexico providers are not required to use these resources; they are offered as a convenience.

• CDC information on opioids for providers
• Opioid risk self-screening tool for patients
• Sample opioid consent form for patients
• Sample agreement forms (contracts) for patients

True Health New Mexico offers an electronic prior authorization (PA) option for providers who submit pharmacy PAs. Electronic PAs can reduce the amount of paperwork you have to do, can cut down on phone calls, and may provide you with faster responses. You also can track the status of your electronic PAs.

We have partnered with Surescripts for electronic pharmacy PAs. Download these guides and learn more at https://providerportal.surescripts.net/ProviderPortal/login.

• Electronic pharmacy prior authorization: How it works
• Surescripts pharmacy prior authorization portal guide