This bill aims to amend the West Virginia Code to promote the use of non-opioid medications for pain management by prohibiting discrimination against these drugs by insurance providers, including the Public Employees Insurance Agency and the Bureau for Medical Services. It establishes that non-opioid drugs must be placed in the lowest formulary tier, which is typically reserved for generic medications with the lowest copays, ensuring that they are competitively accessible compared to opioid medications. The bill also includes provisions for utilization review, allowing for the assessment of the necessity and efficiency of the prescribed treatments.

Additionally, the bill modifies existing laws regarding opioid prescriptions by requiring healthcare practitioners to inform patients about non-opioid alternatives and to document discussions about these options. It emphasizes the patient's right to refuse opioid prescriptions and mandates that insurance providers cover non-opioid medications when prescribed for pain treatment. The legislation includes new definitions for terms such as "nonopioid," "formulary," and "tier," and outlines the responsibilities of healthcare practitioners in discussing treatment options with patients.

Statutes affected:
Introduced Version: 16-54-3, 16-54-8, 5-16-7h, 9-5-33, 16-54-8a, 33-15-4y, 33-16-3ii, 33-24-7z, 33-25-8w, 33-25A-8w