Senate Bill 2388

AN ACT TO PROVIDE THAT THE DIVISION OF MEDICAID, IN ESTABLISHING AND MAINTAINING THE PREFERRED DRUG LIST, SHALL ENSURE THAT NO NONOPIOID DRUG APPROVED BY THE UNITED STATES FOOD AND DRUG ADMINISTRATION FOR THE TREATMENT OR MANAGEMENT OF PAIN SHALL BE DISADVANTAGED OR DISCOURAGED WITH RESPECT TO COVERAGE RELATIVE TO ANY OPIOID OR NARCOTIC DRUG FOR THE TREATMENT OR MANAGEMENT OF PAIN ON SUCH PREFERRED DRUG LIST; TO PROVIDE THAT THE STATE HEALTH PLAN SHALL DEVELOP A PLAN TO PROVIDE ADEQUATE COVERAGE AND ACCESS TO A BROAD SPECTRUM OF PAIN MANAGEMENT SERVICES THAT SERVE AS ALTERNATIVES TO THE PRESCRIBING OF OPIOID DRUGS; AND FOR RELATED PURPOSES.

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

SECTION 1. Pain relief parity in Medicaid. (1) In establishing and maintaining the preferred drug list, the division shall ensure that no nonopioid drug approved by the United States Food and Drug Administration for the treatment or management of pain shall be disadvantaged or discouraged with respect to coverage relative to any opioid or narcotic drug for the treatment or management of pain on such preferred drug list, where impermissible disadvantaging or discouragement includes, without limitation: designating any such nonopioid drug as a nonpreferred drug if any opioid or narcotic drug is designated as a preferred drug; or establishing more restrictive or more extensive utilization controls, including, but not limited to, more restrictive or more extensive prior authorization or step therapy requirements, for such nonopioid drug than the least restrictive or extensive utilization controls applicable to any such opioid or narcotic drug.

(2) This section shall apply to a nonopioid drug immediately upon its approval by the United States Food and Drug Administration for the treatment or management of pain, regardless of whether such drug has been reviewed by the division for inclusion on the preferred drug list. This section also applies to drugs being provided under a contract between the division and any managed care organization.

SECTION 2. Pain management plan model. (1) The State Health Plan shall develop a plan to provide adequate coverage and access to a broad spectrum of pain management services, including, but not limited to, nonopioid medicinal drugs or drug products for the treatment or management of pain, and nonpharmacologic, nonoperative pain management modalities, that serve as alternatives to the prescribing of opioid drugs, in accordance with the requirements in subsection (3) of this section and additional guidelines developed by the division.

(2) The State Health Plan shall file a plan required under subsection (1) of this section with the division for approval. In its review, the division shall determine whether the State Health Plan is in compliance with the requirements in subsection (3) of this section, and whether any policies adopted by the State Health Plan may create unduly preferential coverage of and access to opioid drugs.

(3) (a) The State Health Plan shall provide coverage of at least two (2) alternative prescription medication treatment options approved by the Food and Drug Administration for the treatment of pain and that are not Schedule I, II or III controlled substances, and at least three (3) alternative nonpharmacologic treatment modalities.

(b) The State Health Plan may not establish utilization controls, including prior authorization or step therapy requirements, for clinically appropriate nonopioid medicinal drugs or drug products approved by the United States Food and Drug Administration for the treatment or management of pain, that are more restrictive or extensive than the least restrictive or extensive utilization controls applicable to any clinically appropriate opioid drug.

(4) The State Health Plan shall annually distribute educational materials to providers within its network and to members about the pain management access plan and shall make information about their plans publicly available on their website.

SECTION 3. This act shall take effect and be in force from and after July 1, 2025.