WI SB492

Health care plans and self-insured governmental health plans with drug coverage must develop a pain management access plan ensuring coverage for at least 2 FDA-approved nonopioid prescription medications and at least 3 nonpharmacological treatment modalities for pain

Utilization controls (prior authorization, step therapy) for FDA-approved nonopioid pain drugs cannot be more restrictive than controls applicable to opioid or narcotic drugs

Department of Health Services prohibited from disadvantaging nonopioid pain drugs on its preferred drug list relative to opioids, including designating nonopioids as nonpreferred if any opioid is listed

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

Takes effect the first day of the 4th month after publication, applying to policy years beginning January 1 of the following year