Florida Senate - 2025                                    SB 1154
       
       
        
       By Senator Davis
       
       
       
       
       
       5-01366A-25                                           20251154__
    1                        A bill to be entitled                      
    2         An act relating to coverage of prescription drugs for
    3         pain; creating ss. 409.9064 and 409.9746, F.S.;
    4         defining the term “nonopioid pain drug”; requiring the
    5         Medicaid program and Medicaid managed care plans,
    6         respectively, to provide coverage such that nonopioid
    7         pain drugs are not disadvantaged or otherwise
    8         discouraged relative to any opioid or narcotic drug
    9         for pain management or treatment; specifying
   10         prohibited practices in relation to such coverage;
   11         providing an effective date.
   12          
   13  Be It Enacted by the Legislature of the State of Florida:
   14  
   15         Section 1. Section 409.9064, Florida Statutes, is created
   16  to read:
   17         409.9064 Coverage of prescription drugs for pain.—
   18         (1) As used in this section, the term “nonopioid pain drug”
   19  means a nonopioid drug approved by the United States Food and
   20  Drug Administration for the treatment or management of pain.
   21         (2) The agency shall provide coverage that does not
   22  disadvantage or otherwise discourage a nonopioid pain drug
   23  relative to any opioid or narcotic drug for the treatment or
   24  management of pain. Prohibited practices or policies for such
   25  coverage include, but are not limited to, the following:
   26         (a) Designating a nonopioid pain drug as a nonpreferred
   27  drug if any opioid or narcotic drug is designated as a preferred
   28  drug on the mandatory preferred drug list.
   29         (b) Establishing utilization controls for a nonopioid pain
   30  drug which are more restrictive or more extensive than the least
   31  restrictive or extensive utilization controls applicable to any
   32  opioid or narcotic drug used for treatment of the same
   33  condition, including, but not limited to, imposing more
   34  restrictive or more extensive prior authorization or step
   35  therapy requirements for the nonopioid pain drug.
   36         Section 2. Section 409.9746, Florida Statutes, is created
   37  to read:
   38         409.9746 Managed care plan coverage of prescription drugs
   39  for pain.—
   40         (1) As used in this section, the term “nonopioid pain drug”
   41  means a nonopioid drug approved by the United States Food and
   42  Drug Administration for the treatment or management of pain.
   43         (2) A managed care plan must provide coverage that does not
   44  disadvantage or otherwise discourage a nonopioid pain drug
   45  relative to any opioid or narcotic drug for the treatment or
   46  management of pain. Prohibited practices or policies for such
   47  coverage include, but are not limited to, the following:
   48         (a) Designating a nonopioid pain drug as a nonpreferred
   49  drug if any opioid or narcotic drug is designated as a preferred
   50  drug on the mandatory preferred drug list.
   51         (b) Establishing utilization controls for a nonopioid pain
   52  drug which are more restrictive or more extensive than the least
   53  restrictive or extensive utilization controls applicable to any
   54  opioid or narcotic drug used for treatment of the same
   55  condition, including, but not limited to, imposing more
   56  restrictive or more extensive prior authorization or step
   57  therapy requirements for the nonopioid pain drug.
   58         Section 3. This act shall take effect July 1, 2025.