HB 20-1085: Prevention of Substance Use Disorders

• Health benefit plans must cover minimum nonpharmacological alternatives to opioids: 6 physical therapy visits, 6 occupational therapy visits, 6 chiropractic visits, and 6 acupuncture visits with cost-sharing capped at primary care visit levels and no prior authorization required (effective January 1, 2022).

• Insurance carriers must provide coverage for at least one atypical opioid (buprenorphine, tramadol, or tapentadol) on the lowest formulary tier without step therapy or prior authorization, and cannot require step therapy for other FDA-approved atypical opioids.

• Prescribers must check the prescription drug monitoring program before prescribing a second fill for opioids or benzodiazepines with limited exceptions (hospice, seizure treatment, alcohol withdrawal, neurological emergencies).

• Establishes competency-based continuing medical education requirements for physicians and physician assistants on opioid prescribing practices, with emphasis on benzodiazepine risks and alternatives to opioids.

• Expands prescription drug monitoring program to track additional controlled substances and drugs with abuse potential, allows medical examiners and coroners to query the program during death investigations, and prohibits carriers from penalizing therapists who disclose patient cost information.