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Medicare Part D Payments for Transmucosal Immediate-Release Fentanyl Drugs

Transmucosal Immediate-Release Fentanyl (TIRF) drugs are a Schedule II controlled substance. Medicare Part D covers TIRF drugs only for managing breakthrough pain in adult cancer patients who are already receiving and are tolerant to around-the-clock opioid therapy for their underlying persistent cancer pain. We will determine whether TIRF drugs were appropriately dispensed in Medicare Part D in accordance with Medicare requirements.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
May 2020 Centers for Medicare and Medicaid Services Medicare Part D Payments for Transmucosal Immediate-Release Fentanyl Drugs Office of Audit Services W-00-20-35846 2021