Bill > A4682

Introduced Session

This bill makes it unlawful when a licensed health care provider prescribes a nonopioid medication to a person covered by a health insurance carrier for the treatment of acute pain and the carrier denies coverage of a nonopioid prescription drug: (1) in favor of an opioid prescription drug; or (2) to require a covered person to try an opioid prescription drug prior to approving the use of a nonopioid prescription drug. "Carrier" is defined in the bill to mean an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State. Under the bill, a carrier that establishes and maintains a drug formulary is to ensure that a nonopioid drug approved by the United States Food and Drug Administration for the treatment or management of pain will not be disadvantaged or discouraged, with respect to coverage or cost-sharing, relative to any opioid or narcotic drug for the treatment or management of pain on the formulary of the carrier under various circumstances. It is not prohibited in the bill for an opioid drug to be preferred over another opioid drug or for a nonopioid drug to be preferred over another nonopioid drug. The provisions of the bill prohibiting denial of a nonopioid prescription drug are also incorporated into the laws governing the required coverage for contracts negotiated by the State Health Benefits Commission and the School Employees' Health Benefits Commission, and in the law overseeing Medicaid.

AI Summary

Committee Categories

Margie Donlon (D)*,  Carol Murphy (D)*,  Anthony Verrelli (D)*,  Mitchelle Drulis (D),  Roy Freiman (D),  Ellen Park (D), 

Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 09/12/2024)

Official Document