SB 158 - This act provides that if an enrollee has an elevated risk of opioid misuse, as defined in the act, the enrollee's health benefit plan shall not deny coverage of a non-opioid prescription drug in favor of an opioid drug, require the enrollee to try an opioid drug before covering the non-opioid prescription drug, or require a higher level of cost-sharing for a non-opioid prescription drug than for an opioid drug.

No health benefit plan shall require submission of more documentation than the prescribing health care professional's clinical notes in order to determine whether an enrollee has an elevated risk of opioid misuse.

This act shall apply to health benefit plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2026.

ERIC VANDER WEERD

Statutes affected:
Introduced (1133S.01): 376.1280

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Senate Committee Minutes:
SENATE COMMITTEE MINUTES Bill No.: SB 158
Sponsor: Henderson
Hearing Date: 2/18/2025


COMMITTEE: Insurance and Banking

CHAIRMAN: Crawford

DATE REFERRED: 1/23/2025 DATE HEARING REQUESTED: 1/24/2025



STAFF:
Barbara Mustoe
Scott Svagera
Eric Vander Weerd


WITNESSES GIVING INFORMATION:



WITNESSES FOR:
David Winton - National Association of Social Workers MO-Chapter/Reach Foundation/Gateway Foundation
Alex Eaton - PreventEd
Henrio Thelemaque - Missouri Pharmacy Association/Addicted Recovery Centers of America
Sarah Schlemeier - American College of Ob/Gyns
Arnie C. AC Dienoff


WITNESSES AGAINST:
Hampton Williams - Missouri Insurance Coalition
Shannon Cooper - America's Health Insurance Plans/Blue Cross Blue Shield of Kansas City