AL SB161

Amends Section 22-6-123 of Alabama Code to require the Medicaid Pharmacy and Therapeutics Committee to ensure FDA-approved nonopioid pain medications receive coverage no less restrictive than opioid pain medications on the preferred drug list.

Defines "disadvantaged" as excluding nonopioid drugs from the preferred drug list or imposing more restrictive utilization controls such as prior authorization or step therapy requirements compared to opioid drugs.

Applies coverage parity requirement immediately upon FDA approval of nonopioid drugs, regardless of whether the Medicaid Pharmacy and Therapeutics Committee has reviewed the drug, and extends to drugs provided through contracts with integrated care networks.

Preserves existing Medicaid appeal processes allowing recipients to appeal prior authorization decisions through the Medicaid fair hearing process and physicians to appeal to Medicaid's Medical Directors.

Becomes effective October 1, 2025.