Read the full stored bill text
Wisconsin Legislature: AB499: Bill Text
Skip navigation
Home
Documents
Senate
Assembly
Committees
Service Agencies
Docs
Options
Help
2025 Biennium
Statutes
Admin. Rules
Indices
Miscellaneous
Archives
Home
Bill, Rule, and Appointment Histories
Senators
Representatives
Committees
Text of Introduced Proposals
Amendment Text
Acts
Veto Messages
Enrolled Bills
Votes
Assembly and Senate Floor Calendars
Schedule of Committee Activities
Assembly and Senate Journals
Committee Records (ROCPs)
Legislative Rules
All Session-Related Documents
Subject Index to Acts
Subject Index to Legislation
Subject Index to Journals
Author Index to Legislation
Subject Index to Clearinghouse Rules
Miscellaneous Budget Documents
Executive Orders
Rulings of the Chair
Wisconsin Supreme Court Rules
Opinions of the Attorney General
Town Law Forms
Law
Districts
Session
Drafting Files
Feeds
Preferences
Show tree
Hide tree
Feedback
Help
Home
Senate Home
Senators
Committees
Session
Chief Clerk
Sergeant at Arms
Civics Education
Human Resources
Assembly Home
Representatives
Committees
Session
Chief Clerk
Sergeant at Arms
Human Resources
Schedule
Joint
Senate
Assembly
Study
Legislative Audit Bureau
Legislative Council
Legislative Fiscal Bureau
Legislative Human Resources Office
Legislative Reference Bureau
Legislative Technology Services Bureau
Menu
»
2025
»
Related Documents
»
Proposal Text
»
AB499: Bill Text
Up
Up
2025 - 2026 LEGISLATURE
LRB-2530/1
EKL&SWB:emw
2025 ASSEMBLY BILL 499
October 9, 2025 - Introduced by Representatives
Moses
,
Armstrong
,
Behnke
,
Duchow
,
Gundrum
,
Knodl
,
Melotik
,
Mursau
,
O'Connor
,
Wichgers
and
Murphy
, cosponsored by Senators
James
,
Dassler-Alfheim
and
Keyeski
. Referred to Committee on Insurance.
AB499,1,3
1
An Act
to create
49.45 (49m) (e) and 632.854 of the statutes;
relating to:
2
coverage of nonopioid drug alternatives for the treatment and management of
3
pain.
Analysis by the Legislative Reference Bureau
This bill requires health care insurance plans and self-insured governmental health plans that provide drug coverage to develop and implement a pain management access plan to ensure adequate coverage and access to a broad spectrum of pain management alternatives to opioid drugs. Under the bill, the health care plan or self-insured plan must provide coverage for at least two prescription medication treatment options that are approved by the U.S. Food and Drug Administration for the treatment or management of pain and are not schedule I, II, or III controlled substances. The health care plan or self-insured plan must also provide coverage for at least three alternative nonpharmacological treatment modalities. The bill prohibits the health care plan or self-insured plan from establishing utilization controls for clinically appropriate, FDA-approved nonopioid drugs or drug products that are more restrictive or extensive than utilization controls applicable to an opioid or narcotic drug. Also under the bill, the health care plan or self-insured plan must provide information about the pain management access plan to enrollees and health care providers and make the plan publicly available on its website.
The bill prohibits the Department of Health Services from disadvantaging or discouraging the inclusion on its preferred drug list of a nonopioid drug that is approved by the FDA for the treatment or management of pain relative to the inclusion of an opioid or narcotic drug for the treatment or management of pain.
This proposal may contain a health insurance mandate requiring a social and financial impact report under s. 601.423, stats.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
AB499,1
1
Section
1
.
49.45 (49m) (e) of the statutes is created to read:
AB499,2,7
2
49.45 (
49m
) (e) In maintaining the list under par. (c) 1., the department may
3
not disadvantage or discourage the inclusion on the list of a nonopioid drug that is
4
approved by the federal food and drug administration for the treatment or
5
management of pain relative to an opioid or narcotic drug for the treatment or
6
management of pain. For purposes of this paragraph, prohibited actions include all
7
of the following:
AB499,2,10
8
1. Designating a nonopioid drug for the treatment or management of pain as
9
a nonpreferred drug if any opioid or narcotic drug for the treatment or management
10
of pain is listed.
AB499,2,15
11
2. Establishing utilization controls, including prior authorization or step
12
therapy requirements, that are more restrictive or extensive for a nonopioid drug
13
for the treatment or management of pain than the least restrictive or extensive
14
utilization controls applicable to an opioid or narcotic drug for the treatment or
15
management of pain.
AB499,2
16
Section
2
.
632.854 of the statutes is created to read:
AB499,2,17
17
632.854 Pain management access plan and coverage. (1)
Definitions
.
AB499,2,18
18
(a) “Health care plan” has the meaning given in s. 628.36 (2) (a) 1.
AB499,3,2
19
(b) “Pain management alternatives” means nonopioid medicinal drugs and
1
drug products for the treatment or management of pain and nonpharmacological
2
pain management treatment modalities.
AB499,3,3
3
(c) “Self-insured health plan” has the meaning given in s. 632.85 (1) (c).
AB499,3,9
4
(2)
Requirements.
A health care plan or self-insured health plan that
5
provides coverage for prescription drugs shall develop and implement a pain
6
management access plan to provide adequate coverage and access to a broad
7
spectrum of pain management alternatives. Under the pain management access
8
plan, the health care plan or self-insured health plan shall meet all of the following
9
requirements:
AB499,3,13
10
(a) Provide coverage for at least 2 alternative prescription medication
11
treatment options that are approved by the federal food and drug administration for
12
the treatment or management of pain and that are not controlled substances
13
included in schedule I, II, or III under ch. 961.
AB499,3,15
14
(b) Provide coverage for at least 3 alternative nonpharmacological pain
15
management treatment modalities.
AB499,3,21
16
(c) Not require a utilization control, including a prior authorization or step
17
therapy requirement, for a clinically appropriate nonopioid medicinal drug or drug
18
product approved by the federal food and drug administration for the treatment or
19
management of pain that is more restrictive or extensive than the least restrictive
20
or extensive utilization control applicable to an opioid or narcotic drug approved for
21
the treatment or management of pain.
AB499,4,2
22
(3)
Distribution of pain management information
. A health care plan or
23
self-insured health plan that is required to develop and implement a pain
24
management access plan under sub. (2) shall annually distribute information about
1
the pain management access plan to enrollees and health care providers and shall
2
make the pain management access plan publicly available on its website.
AB499,3
3
Section
3
. Initial applicability.
AB499,4,6
4
(
1
)
For policies and plans containing provisions inconsistent with this act, this
5
act first applies to policy or plan years beginning on January 1 of the year following
6
the year in which this subsection takes effect, except as provided in sub. (2).
AB499,4,11
7
(
2
)
For policies and plans that are affected by a collective bargaining
8
agreement containing provisions inconsistent with this act, this act first applies to
9
policy or plan years beginning on the effective date of this subsection or on the day
10
on which the collective bargaining agreement is newly established, extended,
11
modified, or renewed, whichever is later.
AB499,4
12
Section
4
. Effective date.
AB499,4,14
13
(
1
)
This act takes effect on the first day of the 4th month beginning after
14
publication.
AB499,4,15
15
(end)
Down
Down
/2025/related/proposals/ab499
true
proposaltext
/2025/related/proposals/ab499
proposaltext/2025/REG/AB499
proposaltext/2025/REG/AB499
section
true
Menu
»
2025
»
Related Documents
»
Proposal Text
»
AB499: Bill Text
×
Details for
PDF view
Link
(Permanent link)
Bookmark this location
View toggle
Go to top of document
Search in this chapter
Search in this section
Search in this agency
Search in this chapter group
Search in this chapter
Search in this section
Cross references for section
Acts affecting this section
References to this
1970 Statutes Annotations
Appellate Court Citations
Administrative Code Index
Reference lines
Clear highlighting