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HB 326

COURTS-TECH

104th Regular Session Introduced by Chris Welch

House Bill 326 mandates equal coverage for nonopioid pain management drugs in the state health plan, improving access and reducing opioid-related costs for state employees.

Rule 19(a) / Re-referred to Rules Committee
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Bill Summary · HB 326

Summary of House Bill 326: State Health Benefit Plan Nonopioid Coverage Parity Act

Bill Number: HB 326
Introduced: February 6, 2025
Status: House Second Readers
Classification: Bill

Purpose and Intent

House Bill 326, known as the State Health Benefit Plan Nonopioid Coverage Parity Act, aims to address the opioid epidemic by mandating that the state health benefit plan provides coverage for nonopioid pain management drugs that is equal to the coverage provided for opioid pain management drugs. The bill seeks to reduce the financial burden on the state associated with opioid-related issues, including healthcare costs and lost productivity.

Key Provisions

  1. Coverage Mandate:

    • The state health benefit plan must cover qualifying nonopioid pain management drugs with the same terms as opioid pain management drugs, including:
      • Annual deductibles
      • Coinsurance
      • Copayments
      • Exclusions and reductions
      • Utilization review processes

  2. Definitions:

    • Qualifying Nonopioid Pain Management Drugs: These are drugs approved by the FDA for reducing postoperative or acute pain, which do not act on opioid receptors, are not classified as Schedule I or II controlled substances, and are included in the formulary by the Department of Community Health.
    • Healthcare Provider: Includes pharmacies, physicians, and any licensed entity providing healthcare.
    • Prior Authorization: Requirement for healthcare providers to obtain approval before dispensing certain drugs.

  3. Restrictions on Utilization Management:

    • The bill prohibits the imposition of step therapy for nonopioid pain management drugs, meaning patients cannot be required to try opioid medications before receiving nonopioid prescriptions.
    • Prior authorization for nonopioid drugs cannot be more stringent than for opioid drugs.

  4. Effective Date:

    • The provisions of this act will take effect on January 1, 2026.

  5. Repeal of Conflicting Laws:

    • Any existing laws that conflict with this act will be repealed.

Impact

  • Who is Affected:

    • State employees enrolled in the state health benefit plan will benefit from improved access to nonopioid pain management options.
    • Healthcare providers will have clearer guidelines regarding the prescription of nonopioid medications.
    • The state may see a reduction in costs associated with opioid prescriptions and related health issues.

  • Legislative Findings:

    • The General Assembly recognizes the significant costs of the opioid epidemic and believes that providing parity in coverage for nonopioid medications will help mitigate these costs.

Conclusion

House Bill 326 represents a proactive approach to addressing the opioid crisis by promoting the use of nonopioid pain management alternatives. By ensuring that these alternatives are covered equally under the state health benefit plan, the bill aims to improve healthcare outcomes and reduce the financial impact of opioid misuse on the state.

Compiled from official sources — confirm details with the bill’s official record.

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