SB26-006 • 2026

Parity for Non-Opioid Pain Management Drugs

The bill requires a health insurance carrier that provides prescription drug benefits to require that: The utilization review requirements, including prior authorization and step therapy, for a non-op

Labor

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor: Sen. J. Amabile, Rep. K. Brown
Last action: 2026-04-08
Official status: Senate Committee on Health & Human Services Refer Amended to Appropriations
Effective date: Not listed

Plain English Breakdown

Checked against official source text during the last sync.

Equal Treatment for Non-Opioid Pain Medicines

This bill requires health insurance companies to treat non-opioid pain medicines equally with opioid pain medicines in terms of approval processes and cost.

What This Bill Does

Health insurance companies must not have stricter rules for approving non-opioid pain medicines than they do for opioids.
There needs to be at least one good non-opioid medicine option available for every opioid medicine.
The costs that patients pay out of pocket for non-opioid pain medicines cannot be higher than those for opioid medicines.

Who It Names or Affects

People who have health insurance and need prescription drugs to manage chronic or acute pain
Health insurance companies that provide drug benefits

Terms To Know

Prior Authorization: A process where a doctor needs approval from an insurance company before prescribing certain medicines.
Step Therapy: A requirement that patients try less expensive or lower-risk treatments first before getting more costly ones.

Limits and Unknowns

The bill does not specify what happens if a referendum petition is filed against it.
It's unclear how the new rules will be enforced and monitored by health insurance companies.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

L.001

SEN Health & Human Services

Passed [*]

Plain English: The amendment removes certain sections of the bill and adds a requirement that health insurance carriers must ensure there is at least one non-opioid prescription drug available as an appropriate alternative to opioid drugs.

Removes specific sections from pages 3 and 4 of the original bill text.
Adds new language requiring health insurance plans to provide at least one non-opioid prescription drug as a clinically appropriate alternative for opioids.

The exact impact on existing opioid treatment policies is not detailed in this amendment.

L.004

SEN Health & Human Services

Passed [*]

Plain English: The amendment to SB26-006 adds an exception for group benefit plans issued under the State Employee Group Benefits Act, excluding them from certain requirements.

Adds a new subsection (b) after existing subsection (2.5), which excludes group benefit plans issued under the 'State Employee Group Benefits Act' from being subject to the provisions of subsection (2.5).

The amendment text does not provide details about what specific requirements are excluded for these group benefit plans, only that they do not apply.

Bill History

2026-04-08 Senate
Senate Committee on Health & Human Services Refer Amended to Appropriations
2026-04-02 Senate
Senate Committee on Health & Human Services Witness Testimony and/or Committee Discussion Only
2026-01-14 Senate
Introduced In Senate - Assigned to Health & Human Services

Official Summary Text

The bill requires a health insurance carrier that provides prescription drug benefits to require that:
The utilization review requirements, including prior authorization and step therapy, for a non-opioid drug prescribed and approved by the federal food and drug administration (FDA) for the treatment or management of chronic or acute pain (non-opioid pain management drug) are no more restrictive than the least restrictive utilization review requirements for opioid drugs prescribed for the treatment or management of chronic or acute pain;
There is at least one clinically appropriate non-opioid prescription drug available as an alternative for each opioid prescription drug; and
The cost-sharing, copayment, or deductible for a non-opioid pain management drug is not greater than the cost-sharing, copayment, or deductible for an opioid drug prescribed for the treatment or management of chronic or acute pain.
The bill requires the department of health care policy and financing to ensure that the utilization review requirements, including prior authorization or step therapy, for a non-opioid prescription drug prescribed and approved by the FDA for the treatment or management of chronic or acute pain are no more restrictive than the least restrictive utilization requirements for opioid drugs prescribed for the treatment or management of chronic or acute pain.
(Note: This summary applies to this bill as introduced.)

Current Bill Text

Read the full stored bill text

Second Regular Session
Seventy-fifth General Assembly
STATE OF COLORADO
INTRODUCED

LLS NO. 26-0027.01 Shelby Ross x4510 SENATE BILL 26-006
Senate Committees House Committees
Health & Human Services
A BILL FOR AN ACT
CONCERNING PARITY FOR THE USE OF NON-OPIOID PAIN MANAGEMENT101
DRUGS.102
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov.)
The bill requires a health insurance carrier that provides
prescription drug benefits to require that:
! The utilization review requirements, including prior
authorization and step therapy, for a non-opioid drug
prescribed and approved by the federal food and drug
administration (FDA) for the treatment or management of
SENATE SPONSORSHIP
Amabile and Michaelson Jenet,
HOUSE SPONSORSHIP
Brown,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law.
chronic or acute pain (non-opioid pain management drug)
are no more restrictive than the least restrictive utilization
review requirements for opioid drugs prescribed for the
treatment or management of chronic or acute pain;
! There is at least one clinically appropriate non-opioid
prescription drug available as an alternative for each opioid
prescription drug; and
! The cost-sharing, copayment, or deductible for a
non-opioid pain management drug is not greater than the
cost-sharing, copayment, or deductible for an opioid drug
prescribed for the treatment or management of chronic or
acute pain.
The bill requires the department of health care policy and
financing to ensure that the utilization review requirements, including
prior authorization or step therapy, for a non-opioid prescription drug
prescribed and approved by the FDA for the treatment or management of
chronic or acute pain are no more restrictive than the least restrictive
utilization requirements for opioid drugs prescribed for the treatment or
management of chronic or acute pain.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 10-16-145.5, add2
(2.5) as follows:3
10-16-145.5. Step therapy - prior authorization - prohibited -4
stage four advanced metastatic cancer - non-opioid pain management5
drug - definitions.6
(2.5) N OTWITHSTANDING SECTION 10-16-145, A CARRIER THAT7
PROVIDES PRESCRIPTION DRUG BENEFITS SHALL REQUIRE THAT:8
(a) THE UTILIZATION REVIEW REQUIREMENTS, INCLUDING PRIOR9
AUTHORIZATION AND STEP THERAPY, FOR A NON-OPIOID DRUG PRESCRIBED10
AND APPROVED BY THE FDA FOR THE TREATMENT OR MANAGEMENT OF11
CHRONIC OR ACUTE PAIN ARE NO MORE RESTRICTIVE THAN THE LEAST12
RESTRICTIVE UTILIZATION REVIEW REQUIREMENTS FOR OPIOID DRUGS13
PRESCRIBED FOR THE TREATMENT OR MANAGEMENT OF CHRONIC OR14
SB26-006-2-
ACUTE PAIN;1
(b) THERE IS AT LEAST ONE CLINICALLY APPROPRIATE NON-OPIOID2
PRESCRIPTION DRUG AVAILABLE AS AN ALTERNATIVE FOR EACH OPIOID3
PRESCRIPTION DRUG; AND4
(c) T HE COST -SHARING, COPAYMENT , OR DEDUCTIBLE FOR A5
NON-OPIOID DRUG PRESCRIBED FOR THE TREATMENT OR MANAGEMENT OF6
CHRONIC OR ACUTE PAIN IS NO GREATER THAN THE COST -SHARING,7
COPAYMENT, OR DEDUCTIBLE FOR AN OPIOID DRUG PRESCRIBED FOR THE8
TREATMENT OR MANAGEMENT OF CHRONIC OR ACUTE PAIN.9
SECTION 2. In Colorado Revised Statutes, add 25.5-5-520 as10
follows:11
25.5-5-520. Non-opioid prescription drugs for treating or12
managing chronic or acute pain - no prior authorization or step13
therapy - definition.14
(1) AS USED IN THIS SECTION, UNLESS THE CONTEXT OTHERWISE15
REQUIRES:16
(a) "PRESCRIPTION DRUG" HAS THE SAME MEANING SET FORTH IN17
SECTION 12-280-103.18
(2) T HE STATE DEPARTMENT SHALL REQUIRE THAT THE19
UTILIZATION REVIEW REQUIREMENTS, INCLUDING PRIOR AUTHORIZATION20
OR STEP THERAPY, FOR A NON-OPIOID DRUG PRESCRIBED AND APPROVED21
BY THE FEDERAL FOOD AND DRUG ADMINISTRATION FOR THE TREATMENT22
OR MANAGEMENT OF CHRONIC OR ACUTE PAIN ARE NO MORE RESTRICTIVE23
THAN THE LEAST RESTRICTIVE UTILIZATION REQUIREMENTS FOR OPIOID24
DRUGS PRESCRIBED FOR THE TREATMENT OR MANAGEMENT OF CHRONIC25
OR ACUTE PAIN.26
(3) T HIS SECTION APPLIES TO A FEE -FOR-SERVICE MEDICAL27
SB26-006-3-
ASSISTANCE PLAN AND A HEALTH MAINTENANCE ORGANIZATION THAT HAS1
A CONTRACT WITH THE STATE DEPARTMENT AND PROVIDES COVERAGE FOR2
PRESCRIPTION DRUGS.3
(4) T HIS SECTION DOES NOT PROHIBIT THE STATE DEPARTMENT4
FROM CONTRACTING WITH A MANAGED CARE ORGANIZATION FOR5
PHARMACEUTICAL SERVICES OFFERED UNDER THE STATE MEDICAL6
ASSISTANCE PROGRAM PURSUANT TO THIS ARTICLE 5 AND ARTICLES 4 AND7
6 OF THIS TITLE 25.5 IF THE CONTRACT COMPLIES WITH THIS SECTION.8
SECTION 3. Act subject to petition - effective date. This act9
takes effect at 12:01 a.m. on the day following the expiration of the10
ninety-day period after final adjournment of the general assembly (August11
12, 2026, if adjournment sine die is on May 13, 2026); except that, if a12
referendum petition is filed pursuant to section 1 (3) of article V of the13
state constitution against this act or an item, section, or part of this act14
within such period, then the act, item, section, or part will not take effect15
unless approved by the people at the general election to be held in16
November 2026 and, in such case, will take effect on the date of the17
official declaration of the vote thereon by the governor.18
SB26-006-4-