Bill > HB795

This bill requires health insurers, health care subscription plans, and health maintenance organizations (HMOs) that cover prescription drugs to also cover opioid antagonists, which are medications used to reverse opioid overdoses, such as naloxone. Specifically, these plans must cover at least one prescription opioid antagonist on the lowest cost tier of their drug formulary, and at least one nonprescription (over-the-counter) opioid antagonist. The coverage for these medications cannot be subject to prior authorization (requiring approval before dispensing) or step therapy (requiring patients to try cheaper drugs first). Additionally, pharmacies selling nonprescription opioid antagonists must post a notice informing customers about potential health insurance coverage for these life-saving medications. These provisions will apply to new and renewed insurance policies and plans starting January 1, 2027, and are a recommendation from the Joint Commission on Health Care.

Budget and Finance, Business and Industry, Health and Social Services

https://lis.virginia.gov/bill-details/20261/HB795