Alternatives to PAIN Act
Alternatives to PAIN Act
Plain Language Summary
# Alternatives to PAIN Act Summary **What the bill does:** The Alternatives to PAIN Act would make it easier for Medicare patients to access non-opioid pain management medications. Specifically, it would require these drugs to be covered by Medicare without patients having to pay a deductible, and would place them in the lowest cost-sharing tier available. The bill would also prevent insurance plans from requiring prior authorization (advance approval from the plan before using a drug) or step therapy (being forced to try cheaper or alternative drugs first before coverage kicks in). **Who it affects:** This bill primarily affects Medicare beneficiaries who need pain management medications.
It also impacts prescription drug insurance plans under Medicare and pharmaceutical companies that produce non-opioid pain medications. **Current status:** The bill was introduced in the 119th Congress by Representative Mariannette Miller-Meeks (R-IA) and is currently in committee, meaning it has not yet been debated or voted on by the full House of Representatives. The bill aims to address the opioid addiction crisis by making alternatives to opioids more accessible and affordable for older Americans.
CRS Official Summary
Alternatives to Prevent Addiction In the Nation Act or the Alternatives to PAIN ActThis bill reduces cost-sharing and prohibits the imposition of certain utilization requirements under the Medicare prescription drug benefit for certain non-opioid pain management drugs.Specifically, the bill requires such drugs to be covered without a deductible and to be placed on the lowest cost-sharing tier (if any). The bill also prohibits the imposition of prior authorization requirements (i.e., requiring prior approval from a plan) or step therapy requirements (i.e., requiring the use of alternative drugs before a drug is covered under a plan) with respect to such drugs.
Latest Action
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.