HB 1054 Summary

• Limits outpatient opioid therapy coverage to 30 days following initial injury or discharge without an objectively supportable prescriber's treatment plan, and to 6 weeks without pre-qualification for long-term opioid therapy.

• Establishes long-term opioid maintenance analgesia therapy coverage for chronic nonmalignant, nonterminal pain only if therapy results in greater function, allows return to work, or improves pain control with limited side effects.

• Requires candidates for long-term opioid therapy to have an established chronic pain diagnosis, be unresponsive to non-opioid treatment, not use illegal drugs or abuse alcohol, and be reliable and compliant with treatment protocols.

• Mandates monitoring and documentation requirements including drug screens every 30 days for first 3 months then every 60 days for 6 months, annual evaluations, random drug testing, and treatment agreements with a single prescriber.

• Requires prescriber treatment plans within 30 days of opioid therapy that include time-limited weaning goals, prior medical history review, conservative care summary, risk screening, and signed treatment agreements renewed every 6 months.