Subcommittee reports bill to ease insurance coverage for naloxone, prohibit prior authorization (HB 795)
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Summary
HB 795 would prohibit prior authorization and step therapy for opioid antagonists, require insurers place naloxone on the lowest-cost formulary tier, and mandate coverage of OTC naloxone when available. The committee reported the bill by recorded vote 7–0 after supportive testimony from City of Richmond and other members.
Delegate Reeser presented HB 795, describing measures to improve access to opioid antagonists such as naloxone by prohibiting prior authorization and step therapy for these medications, directing insurers to place naloxone or another opioid antagonist on the lowest-cost formulary tier, and requiring coverage of over-the-counter naloxone when available. Reeser noted that while some insurer formularies may already cover naloxone, prior authorization and cost sharing remain barriers.
Jason Alley of the City of Richmond’s neighborhood and community services office testified the city has among the highest rates of opioid overdoses in the Commonwealth and has used opioid abatement authority funds to expand distribution; he said the city supports HB 795 as a means to scale affordable access to this public-health tool. Delegate Hayes moved to report the bill; the chair announced a recorded vote of 7–0 to report HB 795.
Ending: The committee reported HB 795 to the next stage by recorded vote 7–0; testimony emphasized access barriers and local government support.
