Tennessee Senate Bill SB0428

Tennessee 2025-2026 Regular Session

• Introduced: 1/28/25
• Chaptered: 4/28/25
• Passed: 4/28/25

Caption

AN ACT to amend Tennessee Code Annotated, Title 8; Title 53; Title 56; Title 63; Title 68 and Title 71, relative to the use of drugs for the treatment of pain.

Summary

This bill requires insurers offering certain group insurance plans for state employees to treat FDA-approved non-opioid pain medications more favorably in their preferred drug lists than they would be treated relative to opioid or narcotic pain medications. In practice, an insurer may still prefer one opioid over another opioid, or one non-opioid over another non-opioid, but it may not disadvantage or discourage a qualifying non-opioid pain drug simply because it is compared against an opioid option. The bill defines key terms such as “group insurance plan,” “healthcare prescriber,” “insurer,” and “non-opioid treatment.” Its coverage rule applies to non-opioid drugs that have been FDA-approved for pain treatment or management for at least nine months, including drugs administered through pharmacy benefit manager contracts tied to the group plan. The act takes effect January 1, 2026.

Impact

The bill amends Tennessee Code Annotated Title 56 by adding a new part governing preferred drug lists for state employee group insurance plans. It limits how insurers and pharmacy benefit managers may structure formularies for pain medications by prohibiting discriminatory placement of qualifying non-opioid drugs relative to opioids, while leaving room for tiering within opioid-only or non-opioid-only categories. The practical effect is to expand access and potentially improve coverage positioning for newer non-opioid pain treatments in state employee health plans.

Sentiment

The bill appears to have received strong, bipartisan or at least noncontroversial support in committee and on the floor. It passed the Senate Commerce and Labor Committee unanimously and later passed the Senate Finance, Ways and Means Committee unanimously with amendments, indicating broad agreement with the policy goal of encouraging non-opioid pain management options. The final enactment suggests the measure was viewed favorably by both chambers and the governor.

Contention

The main policy issue is how aggressively the state should steer insurance formularies toward non-opioid pain treatments. Supporters likely favor reducing reliance on opioids and improving access to alternatives, while any concern would center on insurer flexibility, pharmacy benefit manager contracting, and whether the bill could constrain cost-management tools. The bill’s narrow drafting reduces conflict by allowing preference within the same drug class and by applying only after a non-opioid drug has been FDA-approved for nine months or more.