2025 - Introduced
Missouri S.B.158/H.B. 804
  • For enrollees with an increased risk of opioid abuse, prohibits health insurers from: (1) denying coverage for non-opioid prescription drugs in favor of opioid drugs; (2) requiring an enrollee try an opioid prescription drug prior to approving the use of a non-opioid prescription drug; or (3) requiring a higher cost-sharing for non-opioid prescription drugs.
State Regulated Commercial Parity
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2025 - Introduced
Montana H.B. 774
  • Prohibits Medicaid and health insurers from denying coverage of a non-opioid in favor of an opioid and requires that in establishing a drug formulary, the Montana Department of Public Health and Human Services must ensure a non-opioid is not disadvantaged or discouraged as compared to coverage of an opioid.
Medicaid ParityState Regulated Commercial Parity
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2025 - Introduced
Nebraska L.B. 252
  •  Requires Medicaid and commercial plans to treat non-opioid medications equally to opioids, prohibits restrictions, higher cost-sharing, and allows prescribers to override coverage restrictions when appropriate.
  • Takes effect immediately upon FDA approval of a non-opioid drug and aims to improve access to non-opioid pain management.
Medicaid Parity
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2026 - Passed
Nebraska L.R. 482
  • Launches an interim study of access to non-opioid pain management therapies in Nebraska's Medicaid and other health programs, including barriers such as coverage limits, utilization controls, and cost-sharing that may disadvantage non-opioid options compared to opioids.
  • Directs the Legislature to examine the effectiveness, equity, and potential cost savings of evidence-based non-opioid pain treatment options.
Pain Study
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2025 - Passed
Nebraska L.R.219
  • Directs the Nebraska Health and Human Services Committee of the Legislature to create a study to examine non-opioid treatment options in Medicaid.
Pain Study
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2025 - Introduced
Nevada S.B. 377
  • Requires health insurers and Medicaid cover at least one alternative to an opioid and prohibits insurers from requiring prior authorization or other restrictive requirements for an alternative to an opioid compared to requirements established for an opioid.
Medicaid ParityState Regulated Commercial Parity
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2025 - Introduced
New Hampshire H.B.241
  • Requires health insurance plans to cover a broad range of non-opioid pain management services, treat non-opioid therapies no less favorable than opioids, and provide educational materials to policyholders and coordinated care.
State Regulated Commercial Parity
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2026 - Introduced
New Jersey A1821/S.B. 4283
  • Prohibits health insurers from denying coverage of non-opioid prescription drugs in favor of opioid prescription drugs.
State Employee Health Plan ParityMedicaid Parity
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2024 - Introduced
New Jersey A4682
  • Prohibits health insurers, Medicaid and School Employees’ Health Benefits from denying coverage of non-opioid prescription drugs in favor of opioid prescription drugs. Further, formularies are prohibited from disincentivizing the use of non-opioids with respect to coverage or cost-sharing.
Medicaid ParityState Regulated Commercial Parity
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2026 - Passed
New Jersey A5595
  • Allows individuals to create voluntary non-opioid directives, specifying that opioids should not be prescribed or administered, which must be recorded in their medical record and can be revoked at any time.
  • Grants health care providers legal immunity when following the directive.
Opioid Directive
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2026 - Introduced
New York Assembly Bill A1921A
  • Prohibits health insurers and state-regulated plans from disadvantaging clinically appropriate non-opioid pain treatments, including by imposing stricter prior authorization, step therapy, or less favorable tier placement, compared to opioid drugs used for pain.
State Regulated Commercial Parity
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2025 - Passed
North Dakota S.B. 2113
  • Creates a study that will examine non-opioid pharmacological treatment options and assess the use of existing opioid settlement funds. Additionally, the study will explore strategies to utilize these funds for the development and implementation of an education and awareness initiative regarding non-opioid pain management options.
Pain Study
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