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, Sen. B. Kirkmeyer, Rep. K. Brown, Rep. R. Taggart, Sen. S. Bright, Sen. M. Catlin, Sen. J. Coleman, Sen. L. Cutter, Sen. L. Frizell, Sen. B. Pelton, Sen. K. Wallace
Last action: 2026-04-20
Official status: Introduced In House - Assigned to Health & Human Services
Effective date: Not listed

Plain English Breakdown

The official source does not specify the exact date of implementation, which depends on whether a referendum petition is filed against it.

Equal Treatment for Non-Opioid Pain Medicines

This bill requires health insurance companies to treat non-opioid pain medicines no more restrictively than opioids in terms of approval processes, availability, and cost.

What This Bill Does

Requires health insurance companies to have the same or less strict rules for approving non-opioid pain medicines as they do for opioids.
Ensures that there is at least one clinically appropriate non-opioid medicine available for each opioid medicine.
Makes sure that people pay no more out-of-pocket costs for non-opioid pain medicines than they would 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 prescription drug benefits.

Terms To Know

Non-opioid pain management drug: A medicine approved by the FDA for treating pain without being an opioid, such as ibuprofen or acetaminophen.
Prior authorization: When a doctor needs to get approval from an insurance company before prescribing certain medicines.

Limits and Unknowns

The bill does not apply to group benefit plans issued under the State Employee Group Benefits Act.
It is unclear when exactly this bill will take effect, as it depends on whether a referendum petition is filed against it.

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

2026-04-20 House
Introduced In House - Assigned to Health & Human Services
2026-04-20 Senate
Senate Third Reading Passed - No Amendments
2026-04-17 Senate
Senate Second Reading Special Order - Passed with Amendments - Committee
2026-04-17 Senate
Senate Committee on Appropriations Refer Unamended to Senate Committee of the Whole
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
REENGROSSED
This Version Includes All Amendments
Adopted in the House of Introduction
LLS NO. 26-0027.01 Shelby Ross x4510 SENATE BILL 26-006
Senate Committees House Committees
Health & Human Services
Appropriations
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
3rd Reading Unamended
April 20, 2026
SENATE
Amended 2nd Reading
April 17, 2026
SENATE SPONSORSHIP
Amabile and Kirkmeyer, Bright, Catlin, Coleman, Cutter, Frizell, Pelton B., Wallace
HOUSE SPONSORSHIP
Brown and Taggart,
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) (a) NOTWITHSTANDING SECTION 10-16-145, A CARRIER THAT7
PROVIDES PRESCRIPTION DRUG BENEFITS SHALL REQUIRE THAT:8
(I) 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
006-2-
ACUTE PAIN;1
(II) T HERE IS AT LEAST ONE NON -OPIOID PRESCRIPTION DRUG2
AVAILABLE AS A CLINICALLY APPROPRIATE ALTERNATIVE FOR AN OPIOID3
PRESCRIPTION DRUG; AND4
(III) 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
(b) THIS SUBSECTION (2.5) DOES NOT APPLY TO A GROUP BENEFIT10
PLAN ISSUED PURSUANT TO THE "STATE EMPLOYEE GROUP BENEFITS11
ACT", PART 6 OF ARTICLE 50 OF TITLE 24.12
13
SECTION 2. Act subject to petition - effective date. This act14
takes effect at 12:01 a.m. on the day following the expiration of the15
ninety-day period after final adjournment of the general assembly (August16
12, 2026, if adjournment sine die is on May 13, 2026); except that, if a17
referendum petition is filed pursuant to section 1 (3) of article V of the18
state constitution against this act or an item, section, or part of this act19
within such period, then the act, item, section, or part will not take effect20
unless approved by the people at the general election to be held in21
November 2026 and, in such case, will take effect on the date of the22
official declaration of the vote thereon by the governor.23
006-3-