Hearing held on Nonopioid Coverage Parity Act to expand state health-plan coverage of alternatives to opioids

Lawmakers heard testimony on HB 326, the Nonopioid Coverage Parity Act, a bill sponsored by Representative Michelle Au that would require the State Health Benefit Plan (SHBP) to provide coverage for qualifying nonopioid pain medications on terms no less favorable than coverage for opioid medications.

Representative Michelle Au, an anesthesiologist, told the committee the measure is narrowly tailored to the SHBP (not Medicaid) as a pilot to assess effectiveness and fiscal impacts. She said short postoperative opioid exposure "—three to five days"—can sharply increase the risk of dependence and argued that insurance coverage sometimes biases prescribing toward opioids when alternatives are not covered. "The state health benefit plan will cover qualifying nonopioid pain medications at rates no less favorable than those covering opioid-based pain medications," Au said while walking members through the informational packet she provided.

Medical witnesses and clinicians testified in support. Dr. John Gleason, a recently retired orthopaedic surgeon, described multimodal pain protocols and said availability is hindered by prior-authorization and formulary limits. "The facilities themselves can take these drugs off of their formulary and just not order it, so it's not available for the providers to use in the facility that they're at," Gleason said. Bob Lane, chief of anesthesiology in Macon, said nonopioid regimens — including long-acting local anesthetics and emerging sodium-channel blockers — can permit major operations with markedly less or no opioid exposure.

Stakeholders from dentistry and recovery communities also supported the bill. Janelle Adams of the Georgia Dental Association said dentists increasingly prefer ibuprofen or acetaminophen after extractions when clinically appropriate. Jeff Breedlove of the Georgia Council for Recovery and Christina Vandiver, a parent who lost a child to opioids, urged the panel to expand safer options that could reduce addiction risk and downstream criminal-justice and health costs.

Committee members asked whether the bill would inadvertently restrict care for patients with chronic conditions such as sickle cell disease; Au responded the bill does not override clinical judgment and would not block opioid access when medically indicated. Members also pressed on whether higher-cost medications such as liposomal bupivacaine (brand name Exparel) would be covered; supporters said the bill is intended to allow coverage decisions to include such medicines when appropriate. The committee designated HB 326 as a hearing-only bill while the Department of Community Health (DCH) and staff complete technical drafting and a fiscal note.

What comes next: Au agreed to work with DCH on fiscal language and return to the committee. No committee vote was taken during the hearing.