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SB 6244

Enacting the pain parity act.

2023-2024 Regular Session Introduced by Ann Rivers

Washington's Pain Parity Act ensures nonopioid pain therapies are treated no worse than opioids in formularies and coverage, boosting patient self-determination and access.

First reading, referred to Health & Long Term Care.
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Bill Summary · SB 6244

Summary of SB 6244 — Pain Parity Act (Washington, 2024 Regular Session)

Overview

SB 6244, introduced January 16, 2024 by Senator Rivers, seeks to establish “pain parity” between nonopioid and opioid treatments for pain. It adds new sections to three chapters of the Revised Code of Washington (RCW) and requires state education efforts for nonopioid pain therapies. The bill is in its first reading and referred to Health & Long Term Care.

Purpose and Intent

  • Affirms that competent adults have the right of self-determination regarding health decisions, including the option to refuse opioid drugs.
  • Promotes the use of nonopioid alternatives for pain treatment and provides official patient education to support informed choices.
  • Establishes parity in formulary design and coverage between nonopioid and opioid treatments to prevent discrimination against nonopioid options.

Key Provisions

Sec. 1 – Education and Self-Determination (RCW 43.70)

  • Declares a patient’s right to self-determination in health decisions, including opioid refusal.
  • Directs the Department to publish an educational pamphlet on nonopioid pain treatments on its website.
  • The pamphlet must align with current CDC clinical guidelines for prescribing opioids and include:
    • Nonopioid drug options and nonpharmacological therapies.
    • Advantages and disadvantages of nonopioid alternatives.

Sec. 2 – Formulary Parity for Nonopioids (RCW 74.09)

  • In establishing formulary and preferred drug lists, authorities must ensure nonopioid pain medications approved by the FDA are not disadvantaged relative to opioids.
  • Prohibited practices include:
    • Designating a nonopioid as nonpreferred simply because an opioid is preferred.
    • Imposing more restrictive utilization controls (e.g., prior authorization, step therapy) on nonopioids than on opioids.
  • Applies to nonopioid drugs immediately upon FDA approval for pain, regardless of whether the drug has been reviewed for inclusion on the formulary.
  • Applies to contracts between the formulary authority and managed care organizations.

Sec. 3 – Formulary Parity for Commercial Insurers (RCW 48.43)

  • Commercial insurers must ensure nonopioid pain medications receive no coverage or cost-sharing disadvantage compared with opioids.
  • Prohibited practices include:
    • More restrictive coverage criteria for nonopioids than for opioids.
    • More restrictive or extensive utilization controls on nonopioids.
    • Higher cost-sharing tiers for nonopioids if the formulary is tiered.
  • Applies immediately upon FDA approval for pain.

Affected Parties

  • Department of Health (education pamphlet publication)
  • State formulary authorities and managed care organizations
  • Commercial insurers and their policyholders
  • Patients and consumers seeking nonopioid pain therapies
  • Healthcare providers advising on pain management options

Timeline and Procedural Notes

  • Status: First reading, referred to Health & Long Term Care.
  • Effective/Action timing: Provisions related to FDA approval apply immediately upon FDA approval of a nonopioid pain medication.
  • No explicit funding or implementation timeline beyond the first reading stage is provided in the text.

Potential Impacts

  • Greater patient autonomy in pain management decisions.
  • Increased access to nonopioid therapies through formulary parity and reduced barriers.
  • Administrative changes for insurers and MCOs to align with parity requirements.
  • Enhanced public awareness via the Department’s educational pamphlet, potentially influencing prescribing patterns and patient expectations.

Notes: The summary reflects the bill text as introduced and current status. If amendments are added, provisions may shift.

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

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