Alternatives to PAIN Act
Take action
Record your position on this measure.
Create an account to record your position, submit testimony, or contact your legislator.
Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To President
- Became Law
Overview
The Alternatives to Prevent Addiction In the Nation Act, or the Alternatives to PAIN Act, aims to improve access to non-opioid pain medications for Medicare recipients. It reduces or eliminates cost-sharing for these drugs and prohibits plans from requiring step therapy or prior authorization before coverage is approved. The bill focuses on ensuring that these medications are readily available without significant financial barriers.
Key provisions
- Eliminates the deductible for qualifying non-opioid pain management drugs.
- Places qualifying non-opioid pain management drugs on the lowest cost-sharing tier.
- Prohibits step therapy requirements for qualifying non-opioid pain management drugs.
- Prohibits prior authorization requirements for qualifying non-opioid pain management drugs.
- Defines ‘qualifying non-opioid pain management drug’ based on FDA approval, lack of opioid receptors, and wholesale acquisition cost.
- Applies these changes starting January 1, 2026.
- Modifies cost-sharing rules for low-income Medicare beneficiaries.
- Reclassifies a previous provision regarding step therapy to align with the new prohibitions.
Who is affected
- Medicare beneficiaries
- Prescription drug plan sponsors
- Individuals experiencing pain
- Healthcare providers
- Pharmaceutical companies (producing qualifying non-opioid pain medications)
Bill text
Read the latest version inline or switch to a previous version.
Text extraction is in progress. View the official source.
Sponsors
Official sponsors from legislative records.
113 on record
Primary sponsor
Cosponsors
Arguments
Reasons offered for and against this legislation.
Arguments in favor
No arguments in favor have been submitted.
Submit yoursArguments opposed
No arguments opposed have been submitted.
Submit yours