An Act to Ensure Access to Nonopioid, Nonnarcotic Medication for Acute Pain Relief
Maine Legislature, Session 131, LD 2096
Committee: Health Coverage, Insurance and Financial Services
Sponsors: JACKSON, STOVER, STEWART, VITELLI, ARATA, CRAFTS, DODGE, MILLIKEN
Amends: 24-A MRSA §4311

Legislative Document
No. 2096
S.P. 889
In Senate, January 3, 2024
An Act to Ensure Access to Nonopioid, Nonnarcotic Medication for 
Acute Pain Relief
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
203.
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by President JACKSON of Aroostook.
Cosponsored by Representative STOVER of Boothbay and
Senators: STEWART of Aroostook, VITELLI of Sagadahoc, Representatives: ARATA of New 
Gloucester, CRAFTS of Newcastle, DODGE of Belfast, MILLIKEN of Blue Hill.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24-A MRSA §4311, sub-§1-B is enacted to read:
1-B.  Access to clinically appropriate nonopioid, nonnarcotic drugs.  For plan years 
beginning on or after the effective date of this subsection, a carrier shall allow an enrollee, 
the enrollee's designee or the person who has issued a valid prescription for the enrollee to 
request and gain access to a clinically appropriate nonopioid, nonnarcotic drug approved 
by the federal Food and Drug Administration for the treatment and management of acute 
pain, as defined in Title 22, section 7246, subsection 1-A, not otherwise covered by the 
health plan. The carrier's process must comply with section 4304 and with this subsection. 
If the carrier approves a request under this subsection for a nonopioid, nonnarcotic drug 
not otherwise covered by the health plan, the carrier must treat the nonopioid, nonnarcotic 
drug as an essential health benefit, including counting any cost sharing toward the plan's 
annual limit on cost sharing and including it when calculating the plan's actuarial value.  
Coverage for nonopioid, nonnarcotic drugs under this subsection may not be more 
restrictive or prohibitive than coverage for an opioid or narcotic drug.  A carrier, in 
establishing criteria for coverage or a prescription drug formulary, may not impermissibly 
disadvantage or discourage the use of the nonopioid, nonnarcotic drug for the treatment or 
management of acute pain, including by:
A.  Establishing coverage criteria for the nonopioid, nonnarcotic drug that are more 
restrictive than the least restrictive coverage criteria for an opioid or narcotic drug for 
the same or similar management or treatment of acute pain;
B.  Notwithstanding section 4304, establishing prior authorization requirements for the 
nonopioid, nonnarcotic drug that are more restrictive or more extensive than the least 
restrictive or least extensive prior authorization requirements for an opioid or narcotic 
drug for the same or similar management or treatment of acute pain; 
C.  Notwithstanding section 4320-N, establishing step therapy protocols for the 
nonopioid, nonnarcotic drug that are more restrictive or more extensive than the least 
restrictive or least extensive step therapy protocols for an opioid or narcotic drug for 
the same or similar management or treatment of acute pain; or
D.  Establishing other utilization management requirements or quantity or frequency 
of use limits for the nonopioid, nonnarcotic drug that are more restrictive than the least 
restrictive requirements or limits for an opioid or narcotic drug for the same or similar 
management or treatment of acute pain.
The requirements of this subsection apply to a nonopioid, nonnarcotic drug upon the 
approval of that drug by the federal Food and Drug Administration, regardless of whether 
that drug has been reviewed by the Department of Health and Human Services for inclusion 
on a preferred drug list or by a carrier's inclusion on its prescription drug formulary.
SUMMARY
This bill requires a health insurance carrier to allow an insured person to request and 
gain access to a clinically appropriate nonopioid, nonnarcotic drug approved by the federal 
Food and Drug Administration for the treatment and management of acute pain not 
otherwise covered by the insured person's health plan.  A health insurance carrier is 
prohibited from impermissibly disadvantaging or discouraging the use of nonopioid, 
nonnarcotic drugs relative to opioid or narcotic drugs for the same or similar treatment and 
management of acute pain, including by establishing for the nonopioid, nonnarcotic drug, 
in relation to an opioid or narcotic drug: more restrictive coverage criteria; more restrictive 
or extensive preauthorization requirements; more restrictive or extensive step therapy 
protocols; or more restrictive utilization management requirements or quantity or 
frequency of use requirements.
The bill applies to a nonopioid, nonnarcotic drug upon its approval by the federal Food 
and Drug Administration for the treatment or management of acute pain, regardless of 
whether the drug has been reviewed by the Department of Health and Human Services for 
inclusion on a preferred drug list or by health insurance carriers for inclusion on their 
prescription drug formulary.