Us Congress House Bill HB7142

Us Congress 2023-2024 Regular Session

• Introduced: 1/30/24
• Refer: 1/30/24
• Refer: 2/2/24

Caption

Alternatives to PAIN Act Alternatives to Prevent Addiction In the Nation Act

Impact

The bill's enactment may significantly alter the current landscape of pain management within Medicare. Specifically, it mandates that qualifying non-opioid drugs should not incur any cost-sharing or deductibles and must be placed in the lowest cost-sharing tier to facilitate affordability. Such changes are likely to enhance access for patients suffering from pain while encouraging healthcare providers to explore non-opioid alternatives for pain relief, ultimately aiming to reduce risks of addiction associated with opioid use.

Summary

House Bill 7142, known as the Alternatives to Prevent Addiction In the Nation Act, aims to amend Title XVIII of the Social Security Act by ensuring appropriate access to non-opioid pain management drugs under Medicare Part D. The bill seeks to provide Medicare beneficiaries with access to a range of qualifying non-opioid pain management drugs while prohibiting certain practices that may hinder access, such as step therapy and prior authorization requirements. This legislative initiative responds to the serious opioid crisis impacting millions, as it emphasizes reducing dependency on opioids through alternative treatment methods.

Contention

Despite the potential benefits, there may be contention surrounding the implications of restricting insurers from using step therapy or prior authorization for non-opioid drugs. Proponents argue that these practices may delay access to necessary medications; however, opponents might express concerns about overall costs, potential abuse, and whether the measures adequately account for patients who genuinely require prescribed opioids for their pain management. Furthermore, there could be debates on the effectiveness and availability of qualifying non-opioid alternatives in managing various levels of acute and chronic pain.