,,ii  #aai? ,,congress  #a/ ,session    
,s4 #cjfd  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,octob] #bh1 #bjbe ,mr4
 ,da9es 7= himself & ,ms4 ,cantwell7    
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
ensure appropriate access to non-opioid 
pa9 managem5t drugs = *ronic pa9        
conditions "u "p ,d ( ! ,m$ic>e program4
  #a4  ,%ort title  ,?is ,act may be    
cit$ z ! ,relief ( ,*ronic ,pa9 ,act (  
#bjbe4  #b4  ,appropriate co/-%>+ =     
qualify+ non-opioid *ronic pa9 managem5t
 drugs "u ,m$ic>e "p ,d  7a7  ,m$ic>e "p
 ,d  ,section #ahfj;,d-#b ( ! ,social   
,security ,act 7#db ,u4,s4,c4           
#aciew-#ajb7 is am5d$--  7#a7 9         
subsection 7b7-- 7,a7 9 p>agraph        
7#a77;,a71 9 ! matt] prec$+ clause 7i71 
by /rik+ & 7#i7 & ins]t+ 7#i71 & 7#aj72 
7,b7 9 p>agraph 7#b77;,a71 9 ! matt]    
prec$+ clause 7i71 by /rik+ & 7#i7 &    
ins]t+ 7#i71 & 7#aj72 &  7,c7 by add+ at

 ! end ! foll[+ new p>agraph3  7#aj7    
,treatm5t ( co/-%>+ = qualify+          
non-opioid *ronic pa9 managem5t drugs   
7,a7 ,9 g5]al ,= plan ye>s beg9n+ on or 
aft] ,janu>y #a1 #bjbf1 ) respect to a  
cov]$ "p ,d drug t is a qualify+        
non-opioid *ronic pa9 managem5t drug 7z 
def9$ 9 subp>agraph 7,b77--  7i7 !      
d$uctible "u p>agraph 7#a7 %all n apply2
 &  7ii7 su* drug %all be plac$ on !    
l[e/ co/-%>+ ti]1 if any1 = purposes (  
det]m9+ ! maximum co-insurance or o!r   
co/-%>+ = su* drug4  7,b7  ,qualify+    
non-opioid *ronic pa9 managem5t drugs   
,9 ?is p>agraph1 ! t]m qualify+         
non-opioid *ronic pa9 managem5t drug    
means a non-opioid drug or biological   
product--  7i7 t has a label indication 
approv$ by ! ,food & ,drug ,adm9i/ration
 to treat *ronic pa9 or a *ronic pa9    
condition 7z def9$ 9 subp>agraph 7,c772 
7ii7 t does n act ^u ! body's opioid    
receptors2  7iii7 = :i* !re is no o!r   
drug or product t is--  7,i7 rat$ z     
!rapeutically equival5t 7"u ! ,food &   

,drug ,adm9i/ration's mo/ rec5t         
publication ( ,approv$ ,drug ,products )
 ,!rapeutic ,equival5ce ,evaluations72 &
  7,,ii7 sold or m>ket$ 9 ! ,unit$      
,/ates2 &  7iv7 = :i* ! :olesale        
acquisition co/ 7z def9$ 9 section      
#ahdg;,a7c77#f77;,b771 = a mon?ly supply
 does n exce$ ! mon?ly specialty-ti] co/
 ?re%old1 z det]m9$ by ! ,secret>y4     
7,c7  ,*ronic pa9 condition  ,9 ?is     
p>agraph1 ! t]m *ronic pa9 condition    
means ! foll[+ conditions1 ea* *>act]iz$
 by pa9 p]si/+ = a p]iod ( great] ?an #c
 mon?s3  7i7 ,diabetic p]iph]al         
neuropa?ic pa94  7ii7 ,endometriosis4   
7iii7 ,fibromyalgia4  7iv7              
,musculoskeletal pa94  7v7 ,neuropa?ic  
pa94  7vi7 ,po/-h]petic neuralgia4      
7vii7 ,trigem9al neuralgia4  2 &  7#b7 9
 subsection 7c71 by add+ at ! end !     
foll[+ new p>agraph3  7#g7  ,treatm5t ( 
co/-%>+ = qualify+ non-opioid *ronic pa9
 managem5t drugs  ,! cov]age is provid$ 
9 accordance ) subsection 7b77#aj74  4  
7b7  ,con=m+ am5dm5ts to co/-,%>+ =     

l[-,income individuals  ,section        
#ahfj;,d-#ad7;a7 ( ! ,social ,security  
,act 7#db ,u4,s4,c4 #aciew-#aad7;a77 is 
am5d$--  7#a7 9 p>agraph 7#a77;,d71 9   
ea* ( ! clauses 7ii7 & 7iii71 by /rik+  
,subject to p>agraph 7#f7 & ins]t+      
,subject to p>agraphs 7#f7 & 7#g72 &    
7#b7 by add+ at ! end ! foll[+ new      
p>agraph3  7#g7 ,treatm5t ( co/-%>+ or  
d$uctible = qualify+ non-opioid pa9     
managem5t drugs ,= plan ye>s beg9n+ on  
or aft] ,janu>y #a1 #bjbf1 ) respect to 
a cov]$ "p ,d drug t is a qualify+      
non-opioid *ronic pa9 managem5t drug 7z 
def9$ 9 section                         
#ahfj;,d-#b7;b77#aj77;,b77--  7,a7 !    
d$uctible "u section #ahfj;,d-#b7;b77#a7
 %all n apply2 &  7,b7 su* drug %all be 
plac$ on ! l[e/ co/-%>+ ti]1 if any1 =  
purposes ( det]m9+ ! maximum            
co-insurance or o!r co/-%>+ = su* drug4 
4  #c4  ,prohibition on ! use ( /ep     
!rapy & prior au?orization = qualify+   
non-opioid *ronic pa9 managem5t drugs "u
 ,m$ic>e "p ,d  ,section #ahfj;,d-#d7;c7

 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #aciew-#ajd7 is am5d$--  7#a7 
by r$esignat+ p>agraph 7#f71 z add$ by  
section #ejced ( division ,e ( !        
,bip>tisan ,budget ,act ( #bjah 7,public
 ,law #aae-abc71 z p>agraph 7#g72 &     
7#b7 by add+ at ! end ! foll[+ new      
p>agraph3  7#h7  ,prohibition on use (  
/ep !rapy & prior au?orization =        
qualify+ non-opioid *ronic pa9 managem5t
 drugs  7,a7  ,9 g5]al  ,= plan ye>s    
beg9n+ on or aft] ,janu>y #a1 #bjbf1 a  
prescription drug plan or an ,,ma-,,pd  
plan may n1 ) respect to a qualify+     
non-opioid *ronic pa9 managem5t drug 7z 
def9$ 9 section                         
#ahfj;,d-#b7;b77#aj77;,b77 = :i* cov]age
 is provid$ "u su* plan1 impose any--   
7i7 /ep !rapy requirem5t "u :i* an      
individual enroll$ "u su* plan is       
requir$ to use an opioid prior to       
receiv+ su* drug2 or  7ii7 prior        
au?orization requirem5t4  7,b7 ,/ep     
!rapy ,9 ?is p>agraph1 ! t]m /ep !rapy  
means a drug !rapy utilization managem5t

 protocol or program t requires use ( an
 alt]native1 pref]r$ prescription drug  
or drugs be=e ! plan approves cov]age = 
! non-pref]r$ drug !rapy prescrib$4     
7,c7  ,prior au?orization  ,9 ?is       
p>agraph1 ! t]m prior au?orization means
 any requirem5t to obta9 approval f a   
plan prior to ! furni%+ ( a drug4  4