HB 1209 Summary

• Requires insurance policies and HMO contracts to cover brand name tamper-resistant opioids without exclusions or limitations more restrictive than those applied to other prescription drugs.

• Defines "tamper resistant opioid" as an opioid formulated to limit abuse and approved by the FDA with human abuse potential study data showing reduced abuse potential compared to standard opioids.

• Prohibits non-tamper-resistant opioid drugs from being substituted for tamper-resistant opioids and prevents them from being considered therapeutically equivalent.

• Eliminates prior authorization requirements for brand name tamper-resistant opioid coverage when no generic tamper-resistant alternative is available on the market.

• Prohibits conditioning tamper-resistant opioid coverage on prior use of non-tamper-resistant opioid products.

• Effective July 1, 2011 and applies to both accident and sickness insurance policies and HMO contracts.