This bill amends section 68-901 of the Revised Statutes Cumulative Supplement, 2024, to prohibit the disadvantaging or discouraging of Medicaid and commercial insurance coverage for non-opioid drugs prescribed for pain management. The Department of Health and Human Services is required to ensure that non-opioid drugs approved by the federal Food and Drug Administration (FDA) are not treated less favorably than opioid drugs in terms of coverage and utilization controls. The bill specifies that impermissible actions include designating non-opioid drugs as non-preferred or imposing more restrictive prior authorization or step therapy requirements compared to those for opioid drugs. This provision applies immediately upon FDA approval of a non-opioid drug.

Additionally, the bill mandates that commercial insurance policies and self-funded employee benefit plans must also provide equal access to non-opioid drugs, ensuring that coverage criteria and cost-sharing responsibilities do not disadvantage these medications. If a non-opioid drug is restricted, healthcare providers can request an exception based on their professional judgment regarding the appropriateness of the drug for the patient. The intent of the legislation is to enhance access to pain management alternatives and to combat opioid addiction by ensuring that patients have equal access to both non-opioid and opioid treatments. The original section 68-901 is repealed as part of this amendment.

Statutes affected:
Introduced: 68-901