Section 4320-J - Coverage for abuse-deterrent opioid analgesic drug products1.Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings.A. "Abuse-deterrent opioid analgesic drug product" means a brand or generic opioid analgesic drug product approved by the federal Food and Drug Administration with abuse-deterrent labeling claims that indicate the drug product is expected to result in a meaningful reduction in abuse. [2015, c. 371, §1(NEW); 2015, c. 371, §2(AFF).]B. "Cost sharing" means any coverage limit, copayment, coinsurance, deductible or other out-of-pocket expense associated with a health plan. [2015, c. 371, §1(NEW); 2015, c. 371, §2(AFF).]C. "Opioid analgesic drug product" means a drug product in the opioid analgesic drug class prescribed to treat moderate to severe pain or other conditions, whether in immediate release or extended release, long-acting form and whether or not combined with other drug substances to form a single drug product or dosage form. [2015, c. 371, §1(NEW); 2015, c. 371, §2(AFF).] [2015, c. 371, §1(NEW); 2015, c. 371, §2(AFF).]
2. Required coverage. A carrier offering a health plan in this State shall provide coverage for abuse-deterrent opioid analgesic drug products listed on any formulary, preferred drug list or other list of drugs used by the carrier on a basis not less favorable than that for opioid analgesic drug products that are not abuse-deterrent and are covered by the health plan. An increase in enrollee cost sharing to achieve compliance with this section may not be implemented. [2015, c. 371, §1(NEW); 2015, c. 371, §2(AFF).]
Added by 2015, c. 371,§ 1, eff. 10/15/2015.