This bill amends Iowa's Code section 249A.20A to ensure that nonopioid drugs approved by the FDA for pain management are not disadvantaged in Medicaid coverage compared to opioid or narcotic drugs. Specifically, it prohibits designating a nonopioid drug as nonpreferred if any opioid is preferred, and it restricts the establishment of more stringent utilization controls for nonopioid drugs than those applied to opioids. The provisions apply immediately upon FDA approval of a nonopioid drug, regardless of prior review by the medical assistance pharmaceutical and therapeutics committee.

Additionally, the bill requires health carriers to develop and implement a pain management access plan that includes coverage for at least two FDA-approved non-scheduled alternative prescription medications and three nonpharmacologic treatment modalities. The plan must not impose more restrictive utilization controls on nonopioid drugs than those for opioids. Health carriers are also mandated to file their plans with the insurance division for approval, distribute educational materials about the plans, and make them publicly available online. The commissioner of insurance is authorized to adopt rules for the administration of this section.

Statutes affected:
Introduced: 249A.20A