An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, in public assistance, providing for pain parity in Medicaid and for pain parity in commercial insurance.
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Overview
This bill aims to ensure equal access to pain treatment by requiring Medicaid and commercial insurance plans in Pennsylvania to treat non-opioid drugs for pain management similarly to opioid and narcotic drugs. Specifically, it prohibits insurance companies from unfairly disadvantaging non-opioid medications and mandates consistent utilization controls and cost-sharing requirements for these drugs.
Key provisions
- Requires Medicaid to maintain a uniform preferred drug list that doesn't disadvantage non-opioid pain medications compared to opioid medications.
- Prohibits commercial insurers from unfairly disadvantaging non-opioid pain medications on their formularies or preferred drug lists.
- Prevents insurers from imposing more restrictive coverage criteria on non-opioid drugs than on opioid drugs.
- Requires insurers to apply the same utilization controls (like prior authorization) to non-opioid and opioid drugs.
- Specifies that parity applies from the date a non-opioid drug is approved by the FDA for pain management.
- Applies to drugs authorized for use under contracts with managed care organizations.
- Addresses cost-sharing requirements, ensuring they are consistent between opioid and non-opioid pain medications.
- Sets a 60-day timeframe for the bill to take effect.
Who is affected
- Individuals receiving Medicaid benefits
Bill text
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Document of record
- Version
- Pn 1440 Html
- Published
- Not published in the source record
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Sponsors
Official sponsors from legislative records.
6 on record
Primary sponsor
Christine Tartaglione
Cosponsors
Judith Schwank
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