This bill aims to enhance health insurance coverage for nonopioid prescription drugs used in the treatment of pain. It prohibits health insurers from requiring cost-sharing for nonopioid medications or providing less favorable coverage compared to opioid or narcotic drugs. Specifically, when a prescriber recommends a nonopioid drug for acute pain, insurers cannot deny coverage in favor of opioids or mandate that patients try opioids before covering nonopioids. Additionally, insurers must ensure that nonopioid drugs approved by the FDA for pain management are not disadvantaged in terms of coverage or cost-sharing relative to opioids.
The bill also outlines that health insurers must not impose more restrictive coverage criteria or utilization controls on nonopioid drugs than those applied to opioids. This includes restrictions on prior authorization or step therapy requirements and ensuring that nonopioid drugs are not placed in tiers that require higher cost-sharing than the lowest tier for opioids. However, the bill clarifies that it does not prevent the preference of one opioid over another or one nonopioid over another within their respective categories.