Missouri hearing considers bill to require insurers to cover nonopioid options for patients at elevated opioid risk

Representative Melanie Stitt told the House Insurance Committee that House Bill 804 would require insurers to honor a physician-patient decision to use nonopioid pain treatments when a patient is at elevated risk for opioid misuse. "If a patient is at an elevated risk for opioid use, then the insurer cannot deny the non opioid in favor of an opioid. They can't force the patient to try an opioid first, and they can't require higher cost sharing for the non opioid over an opioid," Stitt said.

The bill defines "elevated risk" as meeting one or more criteria listed in the measure: a current or prior diagnosis of a substance use disorder (not limited to opioids); a completed advanced health-care directive stating a preference to avoid opioids; increased risk for overdose or adverse effects based on age or diagnosis; or current prescription medicines that create contraindications with opioids. Stitt said the measure is intended to…