Creates provisions relating to abuse-deterrent opioid analgesic drug products
Summary
HB 1118 repeals and replaces existing Missouri law to address access to abuse-deterrent opioid analgesic drug products. The bill requires MO HealthNet and health insurance carriers or health plans to cover at least one abuse-deterrent opioid analgesic drug product for each opioid active ingredient on their formularies or drug lists, and it defines key terms such as abuse-deterrent opioid analgesic drug product, opioid analgesic drug product, and cost-sharing.
The bill also limits how insurers and health plans may structure coverage for these products. It prohibits prior authorization rules, utilization review measures, or service denials from forcing patients to first use a non-abuse-deterrent opioid before accessing an abuse-deterrent version. For covered brand-name and generic abuse-deterrent products, patient cost-sharing cannot exceed the lowest cost-sharing tier applied to comparable non-abuse-deterrent opioids, and plans may not raise patient cost-sharing or create prescriber/dispensary disincentives to comply with the law.
Impact
The bill would amend Missouri statutes governing MO HealthNet drug therapy review and create a new insurance coverage mandate in section 376.1239. It would affect Medicaid administration, health insurers, and health plans by requiring formulary access to abuse-deterrent opioid products and limiting prior authorization and cost-sharing practices that could discourage their use. The practical effect is to expand patient access to these formulations and constrain plan design around opioid prescribing and coverage.
Sentiment
Based on the bill text and the absence of recorded committee debate or votes in the provided materials, the overall sentiment appears supportive of measures intended to reduce opioid misuse while preserving access to pain medication. The bill’s structure suggests a public health-oriented approach focused on encouraging use of abuse-deterrent formulations rather than restricting opioid treatment outright. No contrary viewpoints are documented in the supplied context.
Contention
The main policy tension is between improving access to abuse-deterrent opioids and preserving insurer flexibility to manage costs and utilization. The bill specifically bars plans from requiring patients to fail on non-abuse-deterrent opioids first, and it prevents higher cost-sharing or other disincentives, which could be viewed by insurers as limiting formulary management tools. On the other hand, patient advocates and public health supporters would likely favor the bill because it reduces barriers to products designed to deter misuse and abuse.