SB 158 - This act provides that if an enrollee has an elevated risk of opioid misuse, as defined in the act, the enrollee's health benefit plan shall not deny coverage of a non-opioid prescription drug in favor of an opioid drug, require the enrollee to try an opioid drug before covering the non-opioid prescription drug, or require a higher level of cost-sharing for a non-opioid prescription drug than for an opioid drug. No health benefit plan shall require submission of more documentation than the prescribing health care professional's clinical notes in order to determine whether an enrollee has an elevated risk of opioid misuse.
This act shall apply to health benefit plans delivered, issued for delivery, continued, or renewed in this state on or after January 1, 2026.
ERIC VANDER WEERD