Title: Health Insurance Coverage for Opioids

Summary: Providing that a health insurance policy that covers opioid analgesic drug products may impose a prior authorization requirement for an abuse-deterrent opioid analgesic drug product only if the insurer imposes the same requirement for each opioid analgesic drug product without an abuse-deterrence labeling claim; prohibiting such health insurance policy from requiring use of an opioid analgesic drug product without an abuse-deterrence labeling claim before providing coverage for an abuse-deterrent opioid analgesic drug product, etc.

Full Text:
WHEREAS, the Legislature finds that the abuse of opioids is a serious problem that affects the health, social, and economic welfare of this state, and WHEREAS, the Legislature finds that an estimated 2.1 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers in 2012, and WHEREAS, the Legislature finds that the number of unintentional overdose deaths from prescription pain relievers has more than quadrupled since 1999, and WHEREAS, the Legislature is convinced that it is imperative for people suffering from pain to obtain the relief they need while minimizing the potential for negative consequences, NOW, THEREFORE, Be It Enacted by the Legislature of the State of Florida: Section 1. Section 627.64194, Florida Statutes, is created to read: 627.64194   Requirements for opioid coverage.  (1) DEFINITIONS.  As used in this section, the term: (a ) Abuse-deterrent opioid analgesic drug product  means a brand or generic opioid analgesic drug product approved by the United States Foo dand Drug Administration with an abuse deterrence labeling claim that indicate sthe drug product is expected to deter abuse. (b)  Opioid analgesic drug product  means a drug product in the opioid analgesic drug class prescribed to treat moderate to severe pain or other conditions in immedia te-release, extended release, or long-acting form regardless of whether or not combined with other drug substances to form a single drug product or dosage form. (2 )  COVERAGE REQUIREMENTS. A health insurance policy that provide scoverage for opioid analgesic drug products: (a) M ay impose a prior authorization requirement for an abuse-deterrent opioid analgesic drug product only if the policy imposes the same prior authorization requirement for each opioid analgesic drug product without an abuse-deterrence labeling claim which is covered by the policy.(b) May not require use of an opi oid analgesic drug product without an abuse-deterrence labeling claim before providing coverage for an abuse-deterrent opioid analgesic drug product. Section 2. This act shall take effect January 1, 2016.