SB 26-6

Senate Bill 26-6, which has been signed into law, aims to ensure that health insurance plans cover non-opioid pain management drugs on par with opioid medications. This means that insurance companies must not impose stricter requirements for prior authorization or higher costs for non-opioid treatments compared to opioids when managing chronic or acute pain. The bill affects individuals who rely on health insurance for pain medication and ensures they have access to affordable, non-opioid options as alternatives to opioids. Since the bill has been signed, it is now law and will impact how insurance companies handle coverage for these medications.

Official Summary

The bill requires a health insurance carrier, except not the state employee group benefits plan, that provides prescription drug benefits to require that:The utilization review requirements, including prior authorization and step therapy, for a non-opioid drug prescribed and approved by the federal food and drug administration (FDA) for the treatment or management of chronic or acute pain (non-opioid pain management drug) are no more restrictive than the least restrictive utilization review requirements for opioid drugs prescribed for the treatment or management of chronic or acute pain;There is at least one clinically appropriate non-opioid prescription drug available as an a clinically appropriate alternative for each an opioid prescription drug; andThe cost-sharing, copayment, or deductible for a non-opioid pain management drug is not greater than the cost-sharing, copayment, or deductible for an opioid drug prescribed for the treatment or management of chronic or acute pain.      The bill requires the department of health care policy and financing to ensure that the utilization review requirements, including prior authorization or step therapy, for a non-opioid prescription drug prescribed and approved by the FDA for the treatment or management of chronic or acute pain are no more restrictive than the least restrictive utilization requirements for opioid drugs prescribed for the treatment or management of chronic or acute pain.(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)

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