Bill > SB5916

This bill mandates that starting January 1, 2027, health plans and healthcare benefit managers (entities that manage prescription drug benefits for health plans) must cover at least one nonopioid drug for pain treatment or management without requiring prior authorization or step therapy protocols, which are processes used to manage drug costs by requiring specific steps before covering certain medications. A "nonopioid drug" is defined as a U.S. Food and Drug Administration-approved medication that relieves pain without affecting the body's opioid receptors. The bill also requires managed care organizations to provide this coverage and directs the state department to create an educational pamphlet on nonopioid pain alternatives by the same date. Additionally, it amends existing law to include "section 1 of this act" within the scope of health plan regulations, ensuring these new nonopioid drug coverage requirements are integrated into the broader legal framework for health insurance.

Health and Social Services

https://app.leg.wa.gov/billsummary?BillNumber=5916&Year=2025&Initiative=false