WI AB499

Health care plans and self-insured governmental health plans must develop and implement a pain management access plan covering at least 2 FDA-approved prescription medications that are not Schedule I, II, or III controlled substances, plus at least 3 nonpharmacological treatment modalities.

Plans are prohibited from imposing utilization controls (such as prior authorization or step therapy) on nonopioid pain medications that are more restrictive than controls applied to opioid or narcotic drugs.

The Department of Health Services cannot disadvantage nonopioid drugs on its preferred drug list relative to opioids, including designating nonopioid pain drugs as nonpreferred if any opioid is listed.

Plans must annually distribute information about their pain management access plan to enrollees and providers and publish the plan on their website.

The act takes effect on the first day of the 4th month after publication, with initial applicability beginning January 1 of the following year for most plans.