HB 1063 Summary

• Organizations may not pay for opioid therapy exceeding 90 morphine milligram equivalents per day or more than a seven-day supply in any single outpatient transaction during the initial 30-day period of therapy.

• Opioid therapy limits do not apply to cancer treatment, end-of-life and hospice care, substance use disorder treatment, emergency rooms, inpatient hospital settings, long-term care facilities, or assisted living facilities.

• Organizations may not pay for benzodiazepine therapy beyond four weeks cumulative duration, except when approved for treatment of anxiety disorders.

• Organizations may not pay for concurrent combination therapies that include medications from both opioid and benzodiazepine categories.

• Injured employees receiving therapy exceeding the established limits must comply by July 1, 2020, at which time organizations shall terminate coverage for therapy exceeding the limits; requests to depart from limits based on medical necessity are subject to dispute resolution proceedings.