Texas House Bill HB3864

Texas 2017 - 85th Regular

Caption

Relating to health benefit plan coverage for abuse-deterrent opioid analgesic drugs.

Impact

The implementation of HB 3864 will mean that health insurers must alter their plans to include abuse-deterrent opioid analgesics, leading to significant changes in how prescriptions for these medications are covered. Insurance providers cannot penalize healthcare professionals for prescribing these drugs, thus ensuring that physicians have the ability to recommend them without fear of reduced payment or other limitations. Additionally, this bill sets forth guidelines regarding prior authorization processes, ensuring that patients are not required to try non-abuse-deterrent opioids prior to receiving these specified medications.

Summary

House Bill 3864, also known as the Act relating to health benefit plan coverage for abuse-deterrent opioid analgesic drugs, mandates that Texas health benefit plans must include coverage for abuse-deterrent opioid analgesics. This legislation aims to enhance patient safety and reduce the risk of opioid misuse by ensuring that approved medications designed to deter abuse are accessible to individuals who require pain management. The bill outlines the types of health benefit plans affected and specifies the definitions of abuse-deterrent opioid analgesics, indicating that these drugs have received FDA approval for their labeling which signals a decrease in potential abuse.

Contention

While supporters of the bill argue that it is a critical step in addressing the opioid crisis by promoting the use of safer medication options, there could be contention regarding the potential financial implications for health insurers and employers. Concerns have been raised about the increased costs associated with providing this coverage and the administration burdens that could arise. Opponents may question whether the legislative mandate adequately addresses broader addiction treatment needs or if it merely shifts the focus to specific drugs without reforming comprehensive addiction recovery strategies.