Bill
Bill > SB492
summary
Introduced
10/02/2025
10/02/2025
In Committee
10/02/2025
10/02/2025
Crossed Over
Passed
Dead
Introduced Session
Potential new amendment
2025-2026 Regular Session
Bill Summary
This bill requires health care insurance plans and self-insured governmental health plans that provide drug coverage to develop and implement a pain management access plan to ensure adequate coverage and access to a broad spectrum of pain management alternatives to opioid drugs. Under the bill, the health care plan or self-insured plan must provide coverage for at least two prescription medication treatment options that are approved by the U.S. Food and Drug Administration for the treatment or management of pain and are not schedule I, II, or III controlled substances. The health care plan or self-insured plan must also provide coverage for at least three alternative nonpharmacological treatment modalities. The bill prohibits the health care plan or self-insured plan from establishing utilization controls for clinically appropriate, FDA-approved nonopioid drugs or drug products that are more restrictive or extensive than utilization controls applicable to an opioid or narcotic drug. Also under the bill, the health care plan or self-insured plan must provide information about the pain management access plan to enrollees and health care providers and make the plan publicly available on its website. The bill prohibits the Department of Health Services from disadvantaging or LRB-4833/1 EKL&SWB:emw 2025 - 2026 Legislature SENATE BILL 492 discouraging the inclusion on its preferred drug list of a nonopioid drug that is approved by the FDA for the treatment or management of pain relative to the inclusion of an opioid or narcotic drug for the treatment or management of pain. This proposal may contain a health insurance mandate requiring a social and financial impact report under s. 601.423, stats.
AI Summary
This bill requires health care insurance plans and self-insured governmental health plans that provide drug coverage to develop and implement a comprehensive pain management access plan designed to ensure patients have alternative options for managing pain beyond opioid medications. Specifically, these plans must provide coverage for at least two FDA-approved prescription medication treatment options for pain that are not schedule I, II, or III controlled substances, as well as at least three alternative nonpharmacological treatment modalities. The bill prohibits these plans from implementing more restrictive utilization controls (such as prior authorization or step therapy requirements) for nonopioid pain medications compared to those applied to opioid drugs. Additionally, the bill mandates that health care plans annually distribute information about their pain management access plan to enrollees and healthcare providers and make this plan publicly available on their website. The legislation also prevents the Department of Health Services from disadvantaging or discouraging the inclusion of nonopioid pain management drugs on its preferred drug list relative to opioid medications. This bill aims to provide patients with more diverse and potentially safer pain management options while ensuring equal treatment for nonopioid alternatives in healthcare coverage and drug lists.
Committee Categories
Health and Social Services
Sponsors (14)
Kristin Dassler-Alfheim (D)*,
Jesse James (R)*,
Sarah Keyeski (D)*,
David Armstrong (R),
Elijah Behnke (R),
Cindi Duchow (R),
Rick Gundrum (R),
Dan Knodl (R),
Paul Melotik (R),
Clint Moses (R),
Dave Murphy (R),
Jeff Mursau (R),
Jerry O'Connor (R),
Chuck Wichgers (R),
Last Action
Available for scheduling (on 01/22/2026)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://docs.legis.wisconsin.gov/2025/proposals/reg/sen/bill/sb492 |
| SB492 ROCP for Committee on Mental Health, Substance Abuse Prevention, Children and Families | https://docs.legis.wisconsin.gov/2025/related/records/senate/mental_health_substance_abuse_prevention_children_and_families/1966909.pdf |
| Senate Amendment 1 | https://docs.legis.wisconsin.gov/document/amends/2025/REG/SB492-SA1.pdf |
| Fiscal Note - SB492: Health Insurance Mandate Report | https://docs.legis.wisconsin.gov/2025/related/fe/sb492/sb492_inins.pdf |
| BillText | https://docs.legis.wisconsin.gov/document/proposaltext/2025/REG/SB492.pdf |
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