Governor Wolf today signed into law two bills of major significance to the Commonwealth’s efforts to tackle the epidemic of addiction and overdose deaths.
Bill 146 is a far-reaching law that includes making drugs available without prior authorization to treat opioid use disorder (MOUD) through commercial insurers and managed care organizations Medicaid (MCO). Bill 111 amends the Controlled Substances, Drugs, Devices and Cosmetics Act to explicitly exclude fentanyl test strips from the definition of drug paraphernalia, thereby legalizing them.
Bill 146 entrenches into law a 2018 agreement Governor Wolf negotiated with commercial insurance companies and a Department of Social Services directive to Medicaid MCOs that guaranteed Pennsylvanians unrestricted access to MOUD when they needed it. need. The new law specifies in particular:
Section 2157. Drug treatment.
(A) Minimum Requirement – An insurer or MA or CHIP managed care plan must make available coverage for at least one prescription drug approved by the United States Food and Drug Administration for use in the drug treatment of opioid use disorder, including coverage for at least one of each of the following without prior approval:
(1) Combined buprenorphine/naloxone product.
(2) Injectable and oral naltrexone.
(B) Level of Coverage and Cost – If a medication-assisted treatment prescription drug listed in subsection (A) is covered as a pharmacy benefit, the insurer or the MA or CHIP managed care plan must cover the prescription drug with the lowest non-preventive cost. health insurance policy or MA or CHIP managed care plan level.
Subsection (B) requires payers to make available the drugs described in subsection (A) at the lowest price for non-preventive drugs.
Previous versions of the bill included language that prevented prior authorization only for initial treatment or prescription, but did not prevent subsequent prior authorizations. In addition, the previous wording also limited the prior authorization waiver to a single drug used to treat OUD. RCPA worked with House leaders and other stakeholders to negotiate broader and more expansive language.
Senator Kristin Phillips-Hill sponsored the bill.
Bill 111 goes beyond fentanyl test strips and excludes from the definition of drug paraphernalia any “testing product used for personal purposes to determine if a controlled substance contains chemicals, toxic substances or hazardous compounds in quantities that could cause physical harm or death”.
In recent years, more laws and public health policies aimed at reducing the harms associated with drug use have been introduced and adopted, marking a significant shift in attitudes and acceptance of harm reduction.
Representative Jim Struzzi sponsored the bill.