A BILL TO BE ENTITLED
AN ACT CONCERNING ABUSE‑DETERRENT OPIOID ANALGESICS.
The General Assembly of North Carolina enacts:
SECTION 1.  Article 3 of Chapter 58 is amended by adding a new section to read:
"§ 58‑50‑305.  Coverage for abuse‑deterrent opioid analgesics.
(a)	As used in this section, the following definitions apply:
(1)	"Abuse‑deterrent opioid analgesic" means a brand or generic opioid analgesic drug product approved by the U.S. Food and Drug Administration (FDA) with abuse‑deterrence labeling claims that indicate the drug product is expected to result in a meaningful reduction in abuse.
(2)	"Cost‑sharing" means any coverage limit, co‑payment, coinsurance, deductible, or other out‑of‑pocket expense requirements.
(3)	"Health benefit plan" has the same meaning as G.S. 58‑3‑167(a)(1).
(4)	"Insurer" has the same meaning as G.S. 58‑3‑167(a)(2).
(5)	"Opioid analgesic" 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.
(b)	Every health benefit plan that provides coverage for prescription drugs shall provide coverage for abuse‑deterrent opioid analgesic drugs on a basis that is no less favorable than the coverage provided for non‑abuse‑deterrent opioid analgesics. Cost‑sharing for abuse‑deterrent opioid analgesics shall not exceed the lowest cost‑sharing level applied to prescription drugs within a health benefit plan. No insurer shall reclassify opioid analgesics, limit coverage for opioid analgesics, or increase cost‑sharing under a health benefit plan to achieve compliance with this subsection.
(c)	No health benefit plan shall require an insured to use, prior to using an abuse‑deterrent opioid analgesic, any non‑abuse‑deterrent opioid analgesic. However, a health benefit plan may require an insured to receive prior authorization for an abuse‑deterrent opioid analgesic, provided that similar prior authorization requirements apply to non‑abuse‑deterrent versions of that opioid analgesic."
SECTION 2.  This act becomes effective October 1, 2015, and applies to insurance contracts issued, renewed, or amended on or after that date.