HB804--INSURANCECOVERAGEOFALTERNATIVESTOOPIOIDDRUGS
SPONSOR: Stinnett
Thisbillprovidesthatifanenrolleehasanelevatedriskof
opioidmisuse,asdefinedinthebill,theenrollee'shealth
benefitplancannotdenycoverageofanon-opioidprescriptiondrug
infavorofanopioiddrug,requiretheenrolleetotryanopioid
drugbeforecoveringthenon-opioidprescriptiondrug,orrequirea
higherlevelofcost-sharingforanon-opioidprescriptiondrug
thanforanopioiddrug.
Nohealthbenefitplancanrequirethesubmissionofmore
documentationthantheprescribinghealthcareprofessional's
clinicalnotesinordertodeterminewhetheranenrolleehasan
elevatedriskofopioidmisuse.
Theprovisionsofthebillwillapplytohealthbenefitplans
delivered,issuedfordelivery,continued,orrenewedinthisState
onorafterJanuary1,2026.
ThisbillissimilartoSB158(2025).