Congress·In Committee·S. 475
Alternatives to PAIN Act
Congress targets lower Medicare drug costs and fewer plan barriers for certain non-opioid pain medicines
Part of: Congress Proposes Expanded Medicare Access to Non-Opioid Pain Medications
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Stalled
No legislative action in over 90 days.
Legislative Progress
Senate
Key Points
- Starting in 2026, Medicare Part D plans would have to cover certain non-opioid pain drugs without applying the Part D deductible.
- These drugs would have to be put on the lowest cost-sharing tier, which is meant to reduce what people pay out of pocket at the pharmacy.
- Medicare drug plans could not require a patient to try an opioid first before getting these non-opioid pain drugs.
- Medicare drug plans also could not require prior approval (prior authorization) before filling these qualifying non-opioid pain prescriptions.
- The bill narrowly targets specific FDA-approved non-opioid pain drugs that don’t have an equivalent alternative on the market and that stay under Medicare’s specialty-tier monthly cost limit.
Impact Analysis
Personal Impact
How this policy affects specific groups of people
Positive Impacts(2)
Milestones
2 milestones2 actions
Feb 6, 2025
Read twice and referred to the Committee on Finance.
Sent to a congressional committee for expert review. The committee decides whether this bill moves forward.
Feb 6, 2025
Introduced in Senate
The bill was officially filed and given a number. It now enters the legislative queue.
Votes
No votes have been recorded for this legislation yet.
Source Information
Document Type
Congressional Bill
Official Title
Alternatives to PAIN Act
Bill NumberS 475
Congress119th Congress
ChamberSenate
Latest ActionRead twice and referred to the Committee on Finance.
Data Sources
Sponsor
Cosponsors
(32)D: 16R: 15I: 1
Analysis generated by AI. Always verify with official sources.