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IN SB0270
Bill
Status
1/7/2016
Primary Sponsor
James Merritt
Click for details
AI Summary
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Requires state employee health plans, Medicaid, accident and sickness insurance policies, and HMO contracts to cover at least one abuse deterrent opioid analgesic for each available opioid agonist active ingredient.
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Defines "abuse deterrent opioid analgesic" as a brand name or generic opioid drug formulated with abuse deterrent properties and FDA-approved labeling indicating the properties deter or reduce abuse.
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Prohibits coverage requirements from being less favorable for abuse deterrent opioids than standard brand name or generic prescription drugs with respect to copayments, deductibles, and coinsurance.
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Prohibits insurers from requiring patients to first try non-abuse deterrent opioids before covering abuse deterrent versions, though utilization review and prior authorization may apply uniformly to all opioids of the same formulation type.
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Applies to state employee health plans, Medicaid programs, accident and sickness insurance policies, and HMO contracts issued, entered into, or renewed after June 30, 2016, effective July 1, 2016.
Legislative Description
Coverage for abuse deterrent opioids. Requires that, if an abuse deterrent opioid analgesic is available with a certain active ingredient, state employee health plans, Medicaid, policies of accident and sickness insurance, and health maintenance organization contracts must provide coverage for at least one abuse deterrent opioid analgesic that provides that active ingredient.
Last Action
First reading: referred to Committee on Health & Provider Services
1/7/2016