MA H1134

MassHealth and contracted insurers must provide coverage for FDA-approved non-opioid pain medications without disadvantaging them relative to opioids through formulary placement or more restrictive prior authorization/step therapy requirements

Medicaid managed care and accountable care organizations must provide comprehensive integrated care for chronic pain patients, including primary care, specialists (pain management, neurology, rheumatology), and specialized providers (physical therapy, chiropractic, acupuncture, psychology, massage therapy)

By fiscal year 2026, Medicaid organizations must implement a chronic pain quality strategy requiring identification of members with chronic pain within 90 days of enrollment, adequate provider networks, care coordination supports, and approved training curricula for primary care providers

The Division of Medical Assistance must identify and share best practices for chronic pain care management with Medicaid providers by January 1, 2026

The Center for Health Information and Analysis must collect data on chronic pain incidence, prevalence, demographics, costs, and treatment effectiveness, publishing a report within 2 years of enactment and every 2 years thereafter