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 in insurance coverage. It introduces new sections that define "nonopioid" drugs and establishes that the Public Employees Insurance Agency, the Bureau for Medical Services, and other insurers cannot disadvantage or discourage non-opioid medications compared to opioid drugs. Furthermore, it mandates that non-opioid drugs be placed in the lowest formulary tier, which is typically reserved for generic medications with the lowest copays, thereby making them more accessible for patients.

Additionally, the bill enhances patient education by requiring healthcare practitioners to inform patients about available non-opioid alternatives before prescribing opioid medications. It also stipulates that insurance providers must cover non-opioid prescriptions when prescribed for pain treatment, ensuring that patients have access to these alternatives without facing coverage denials in favor of opioids. The bill includes provisions for utilization review, allowing insurers to maintain oversight while ensuring that non-opioid options are prioritized in pain management strategies.

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