Easier Access to Non-Opioid Chronic Pain Drugs under Medicare Part D.
This Act improves access for seniors and disabled individuals covered by Medicare Part D to innovative non-opioid treatments for chronic pain. Starting in 2026, qualifying non-opioid drugs will be exempt from deductibles and placed on the lowest cost-sharing tier, significantly reducing out-of-pocket costs. Furthermore, plans cannot require patients to try opioids first or obtain prior authorization, ensuring faster and safer treatment access.
Key points
Eliminates deductibles and mandates the lowest cost-sharing tier for qualifying non-opioid chronic pain drugs under Medicare Part D.
Prohibits "step therapy" requirements that force patients to use an opioid before accessing the non-opioid treatment.
Bans prior authorization requirements for these specific non-opioid drugs, speeding up access to chronic pain relief.
Status:
Introduced
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