HF 1038

as introduced - 89th Legislature (2015 - 2016) Posted on 02/18/2015 11:22am

A bill for an act
relating to insurance; requiring coverage for opioid analgesics with
abuse-deterrent properties; proposing coding for new law in Minnesota Statutes,
chapter 62Q.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [62Q.528] OPIOID ANALGESICS WITH ABUSE-DETERRENT
PROPERTIES.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section, the following terms
have the meanings given them.
new text end

new text begin (b) "Abuse-deterrent opioid analgesic drug product" means a brand or generic opioid
analgesic drug product approved by the United States Food and Drug Administration
(FDA) with abuse-deterrence labeling claims that indicate the drug product is expected to
result in a meaningful reduction in abuse of opioids.
new text end

new text begin (c) "Opioid analgesic drug product" means a drug product in the opioid analgesic
drug class prescribed to treat moderate to severe pain or other conditions and includes
immediate release, extended release, and long-acting forms and whether or not combined
with other drug substances to form a single drug product or dosage form.
new text end

new text begin Subd. 2. new text end

new text begin Required coverage. new text end

new text begin (a) A health plan that provides prescription drug
coverage must provide coverage for abuse-deterrent opioid analgesic drug products as a
preferred drug on the health plan company's drug formulary or preferred drug list.
new text end

new text begin (b) Cost-sharing requirements for abuse-deterrent opioid analgesic drug products
must not exceed the lowest cost-sharing requirements applied to other covered prescription
drugs on the drug formulary or preferred drug list.
new text end

new text begin Subd. 3. new text end

new text begin Prior authorization. new text end

new text begin (a) A health plan company shall not impose as part
of a prior authorization or utilization review requirement the use of a non-abuse-deterrent
opioid analgesic drug product in order to access an abuse-deterrent opioid analgesic drug
product.
new text end

new text begin (b) Nothing in this subdivision prevents a health plan company from applying a
prior authorization requirement to an abuse-deterrent opioid analgesic drug product, so
long as the same prior authorization requirements are applied to non-abuse-deterrent
opioid analgesic drug products.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2015, and applies to any
health plan issued or renewed on or after that date.
new text end