This bill aims to enhance the accessibility and coverage of nonopioid drugs for pain management within Iowa's Medicaid program and health benefit plans. It amends Section 249A.20A of the Code to ensure that nonopioid drugs approved by the FDA for pain treatment are not disadvantaged compared to opioid or narcotic drugs on the preferred drug list. Specifically, it prohibits designating nonopioid drugs as nonpreferred if any opioid is preferred and restricts the imposition of more stringent utilization controls on nonopioid drugs than those applied to opioids. This provision takes effect immediately upon FDA approval of a nonopioid drug, regardless of prior review by the medical assistance pharmaceutical and therapeutics committee.

Additionally, the bill mandates that health carriers develop and implement a pain management access plan that includes coverage for at least two alternative prescription medications and three nonpharmacologic treatment modalities for pain management. The plan must not impose more restrictive utilization controls on nonopioid drugs than those for opioids. Health carriers are required to file their plans with the insurance division for approval and provide educational materials about the plans to healthcare providers and covered persons. The commissioner of insurance is authorized to adopt rules for the administration of this section.

Statutes affected:
Introduced: 249A.20A