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Improved Access to Non-Opioid Pain Management Drugs in Medicare

New rules will make it easier for seniors and Medicare beneficiaries to access non-opioid pain management drugs. This means lower out-of-pocket costs and no prior approval needed for these medications, aiming to combat opioid addiction.
Key points
No deductible for qualifying non-opioid pain management drugs under Medicare Part D starting January 1, 2026.
Non-opioid pain drugs will be placed on the lowest cost-sharing tier, reducing patient expenses.
Prohibition of 'step therapy' (requiring opioid use first) and prior authorization for non-opioid pain medications.
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Status:
Introduced
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Additional Information
Alternatives to PAIN Act
Print number: HR 1227
Sponsor: Rep. Miller-Meeks, Mariannette [R-IA-1]
Process start date: 2025-02-12