This bill prohibits health insurance carriers from denying coverage for nonopioid prescription drugs when prescribed by a licensed healthcare provider for the treatment of acute pain. Specifically, it makes it unlawful for carriers to favor opioid prescription drugs over nonopioid drugs or to require patients to try opioids before approving nonopioid medications. Additionally, if a carrier maintains a drug formulary, it must ensure that nonopioid drugs approved by the FDA for pain management are not disadvantaged in terms of coverage or cost-sharing compared to opioid drugs. The bill allows for the preference of one opioid over another and one nonopioid over another but prohibits any discriminatory practices against nonopioid drugs.

The bill also extends these provisions to contracts negotiated by the State Health Benefits Commission and the School Employees Health Benefits Commission, as well as to the Medicaid program. It mandates that nonopioid medications prescribed for acute pain must be covered without requiring prior use of opioids and ensures that nonopioid drugs are treated equitably in terms of coverage and cost-sharing. The act is set to take effect on January 1, 2027, applying to all relevant policies, plans, and contracts issued or renewed after that date.