Bill > HB804

This bill aims to prevent health insurance plans from discriminating against patients at high risk of opioid misuse when they are prescribed non-opioid pain medications. Specifically, the bill defines "elevated risk of opioid misuse" as including patients with a history of substance use disorder, those who have completed advance health care directives limiting pain control to non-opioid measures, patients with increased risk of opioid overdose or dependency, or those taking medications that interact negatively with opioids. The legislation prohibits health benefit plans from denying coverage of non-opioid pain medications, requiring patients to try opioid drugs first, or imposing higher cost-sharing for non-opioid prescriptions compared to opioid medications. Additionally, the bill prevents insurance companies from requiring extensive documentation beyond a healthcare professional's clinical notes to verify a patient's elevated risk status. The provisions will take effect for health benefit plans delivered, issued, continued, or renewed on or after January 1, 2026, providing a protective measure for patients seeking alternative pain management strategies that reduce opioid-related risks.

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https://house.mo.gov/Bill.aspx?bill=HB804&year=2025&code=R