AHCCCS; prescription drug coverage

Plain English Breakdown

The effective date is missing from the provided official materials; only legislative passage dates are shown.

HB2725: Rules for Opioid and Non-Opioid Drug Coverage in AHCCCS

This law stops health plans from swapping non-opioid pain medicines for opioids and requires that rules for getting non-opioids be no stricter than the easiest rules used for opioid or narcotic drugs.

What This Bill Does

• Stops AHCCCS contractors from replacing a prescribed non-opioid pain drug with an opioid version if treating chronic or acute pain.
• Requires that approval steps like prior authorization and step therapy for non-opioids be no stricter than the least strict rules used for opioids or narcotics.

Who It Names or Affects

• AHCCCS contractors who manage health plans in Arizona
• Licensed physicians prescribing pain medication to AHCCCS members

Terms To Know

Therapeutic substitution

When a health plan replaces one prescribed drug with another similar drug.

Utilization controls

Rules that limit how or when patients can get certain drugs, such as needing approval first.

Limits and Unknowns

• The official text does not state the specific date this law will take effect.
• The bill sets rules for pain drugs but does not list specific non-opioid drug names that are covered.

Official Summary Text

HB2725 - 572R - House Bill Summary

ARIZONA HOUSE OF REPRESENTATIVES

57th
Legislature, 2nd Regular Session

Majority Research Staff

HB2725
:
AHCCCS; prescription drug coverage

Sponsor:
Representative Bliss, LD 1

Committee
on Health & Human Services

Overview

Prohibits
the Arizona Health Care Cost Contain System (AHCCCS) contractors from making a
therapeutic substitution for an opioid drug if a contracted licensed physician
has prescribed a non-opioid drug for chronic or acute pain. Forbids AHCCCS from
establishing more restrictive utilization controls for non-opioid prescription
drugs than those applied to opioid or narcotic drugs.

History

Established in
1981, AHCCCS is Arizona's Medicaid program that oversees contracted health
plans for the delivery of health care to individuals and families who qualify
for Medicaid and other medical assistance programs. Through contracted health
plans across the state, AHCCCS delivers health care to qualifying individuals
including low-income adults, their children or people with certain
disabilities. Members must meet certain financial and nonfinancial requirements
to be eligible for AHCCCS (
A.R.S. � 36-2901
).

Opioids
are natural or synthetic chemicals that bind to
receptors in your brain or body to reduce the intensity of pain signals
reaching the brain. Common prescription opioid drugs include: 1) hydrocodone; 2)
oxycodone; and 3) morphine. Prescription opioids can be used to treat
acute-to-chronic pain and are often prescribed following surgery or injury or
for health conditions such as cancer (
CDC
).

Provisions

1.

Prohibits an
AHCCCS contractor from making a therapeutic substitution for a drug that is an
opioid, if a contracted licensed physician has prescribed a drug that is not an
opioid to treat chronic or acute pain, notwithstanding any other law to the
contrary. (Sec. 1)

2.

Prohibits
AHCCCS from establishing more restrictive or extensive utilization controls,
including more restrictive or extensive prior authorization or step therapy
requirements, for clinically appropriate drugs that are non-opioids than the
least restrictive or extensive utilization controls applicable to any
clinically appropriate prescription that is an opioid or narcotic. (Sec. 1)

3.

4.

5.

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6.

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2725

7.

1/27/2026� Page 0 Health
& Human Services

8.

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Current Bill Text

HB2725 - 572R - I Ver

REFERENCE TITLE:
AHCCCS; prescription drug coverage

State of Arizona

House of Representatives

Fifty-seventh Legislature

Second Regular Session

2026

HB 2725

Introduced by

Representatives
Bliss: Aguilar, Cavero, Hernandez A, Hernandez C, Pe�a, Willoughby;� Senators
Kavanagh, Payne

AN
ACT

Amending title 36, chapter 29, article 1,
Arizona Revised Statutes, by adding section 36-2930.07; relating to the
Arizona health care cost containment system.

(TEXT OF BILL BEGINS ON NEXT PAGE)

Be it enacted by the Legislature of the State of Arizona:

Section 1. Title 36, chapter 29, article 1,
Arizona Revised Statutes, is amended by adding section 36-2930.07, to read:

START_STATUTE
36-2930.07.

Prescription drugs that are not opioids; therapeutic
substitutions; utilization controls

A. Notwithstanding any other law to
the contrary, if a contracted licensed physician has prescribed a drug that is
not an opioid to treat chronic or acute pain, a contractor may not make a
therapeutic substitution for a drug that is an opioid.

B. The administration may not
establish more restrictive or extensive utilization controls, including more
restrictive or extensive prior authorization or step therapy requirements, for
clinically appropriate prescription drugs that are not opioids than the least
restrictive or extensive utilization controls applicable to any clinically
appropriate prescription drug that is an opioid or narcotic.
END_STATUTE