Medicaid and health insurance insurers; create provisions effecting parity in the prescription of pain medication.

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To: Medicaid; Insurance
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Senator(s) Blackwell

SENATE BILL NO. 2025

AN ACT TO PROVIDE THAT THE DIVISION OF MEDICAID, IN 1
ESTABLISHING AND MAINTAINING THE PREFERRED DRUG LIST, SHALL ENSURE 2
THAT NO NONOPIOID DRUG APPROVED BY THE UNITED STATES FOOD AND DRUG 3
ADMINISTRATION FOR THE TREATMENT OR MANAGEMENT OF PAIN SHALL BE 4
DISADVANTAGED OR DISCOURAGED WITH RESPECT TO COVERAGE RELATIVE TO 5
ANY OPIOID OR NARCOTIC DRUG FOR THE TREATMENT OR MANAGEMENT OF 6
PAIN ON SUCH PREFERRED DRUG LIST; TO REQUIRE THAT ANY HEALTH 7
INSURANCE INSURER OFFERING A HEALTH INSURANCE POLICY OR HEALTH 8
BENEFIT PLAN DEVELOP A PLAN TO PROVIDE ADEQUATE COVERAGE AND 9
ACCESS TO A BROAD SPECTRUM OF PAIN MANAGEMENT SERVICES THAT SERVE 10
AS ALTERNATIVES TO THE PRESCRIBING OF OPIOID DRUGS; TO REQUIRE 11
SUCH AN INSURER TO FILE THE PLAN WITH THE DEPARTMENT OF INSURANCE 12
FOR APPROVAL; TO PROVIDE THAT SUCH AN INSURER SHALL ANNUALLY 13
DISTRIBUTE EDUCATIONAL MATERIALS TO PROVIDERS WITHIN ITS NETWORK 14
AND TO MEMBERS ABOUT THE PAIN MANAGEMENT ACCESS PLAN AND SHALL 15
MAKE INFORMATION ABOUT ITS PLAN PUBLICLY AVAILABLE ON ITS WEBSITE; 16
AND FOR RELATED PURPOSES. 17
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 18
SECTION 1. (1) In establishing and maintaining the 19
preferred drug list, the Division of Medicaid shall ensure that no 20
nonopioid drug approved by the United States Food and Drug 21
Administration for the treatment or management of pain shall be 22
disadvantaged or discouraged with respect to coverage relative to 23
any opioid or narcotic drug for the treatment or management of 24
pain on such preferred drug list, where impermissible 25
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disadvantaging or discouragement includes, without limitation: 26
designating any such nonopioid drug as a nonpreferred drug if any 27
opioid or narcotic drug is designated as a preferred drug; or 28
establishing more restrictive or more extensive utilization 29
controls, including, but not limited to, more restrictive or more 30
extensive prior authorization or step therapy requirements, for 31
such nonopioid drug than the least restrictive or extensive 32
utilization controls applicable to any such opioid or narcotic 33
drug. 34
(2) This section shall apply to a nonopioid drug immediately 35
upon its approval by the United States Food and Drug 36
Administration for the treatment or management of pain, regardless 37
of whether such drug has been reviewed by the Division of Medicaid 38
for inclusion on the preferred drug list. This section also 39
applies to drugs being provided under a contract between the 40
Division of Medicaid and any managed care organization. 41
SECTION 2. (1) Any health insurance insurer offering a 42
health insurance policy or health benefit plan shall develop a 43
plan to provide adequate coverage and access to a broad spectrum 44
of pain management services, including, but not limited to, 45
nonopioid medicinal drugs or drug products for the treatment or 46
management of pain, and nonpharmacologic, nonoperative pain 47
management modalities, that serve as alternatives to the 48
prescribing of opioid drugs, in accordance with the requirements 49
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in subsection (3) of this section and additional guidelines 50
developed by the Department of Insurance. 51
(2) Any health insurance insurer offering a health insurance 52
policy or health benefit plan shall file a plan required under 53
subsection (1) of this section with the Department of Insurance 54
for approval. In its review, the Department of Insurance shall 55
determine whether the health insurance policy or health benefit 56
plan is in compliance with the requirements in subsection (3) of 57
this section, and whether any policies adopted by the health 58
insurance insurer offering a health insurance policy or health 59
benefit plan may create unduly preferential coverage of and access 60
to opioid drugs. 61
(3) (a) Any health insurance insurer offering a health 62
insurance policy or health benefit plan shall provide coverage of 63
at least two (2) alternative prescription medication treatment 64
options approved by the United States Food and Drug Administration 65
for the treatment of pain and that are not Schedule I, II or III 66
controlled substances, and at least three (3) alternative 67
nonpharmacologic treatment modalities. 68
(b) No health insurance insurer offering a health 69
insurance policy or health benefit plan shall establish 70
utilization controls, including prior authorization or step 71
therapy requirements, for clinically appropriate nonopioid 72
medicinal drugs or drug products approved by the United States 73
Food and Drug Administration for the treatment or management of 74
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ST: Medicaid and health insurance insurers;
create provisions effecting parity in the
prescription of pain medication.
pain, that are more restrictive or extensive than the least 75
restrictive or extensive utilization controls applicable to any 76
clinically appropriate opioid drug. 77
(4) Any health insurance insurer offering a health insurance 78
policy or health benefit plan shall annually distribute 79
educational materials to providers within its network and to 80
members about the pain management access plan and shall make 81
information about its plan publicly available on its website. 82
SECTION 3. This act shall take effect and be in force from 83
and after July 1, 2026. 84