CHARLESTON, W.Va. – On December 28, 2022, the Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act, legislation introduced by U.S. Senator Shelley Moore Capito (R-W.Va.) and a bipartisan group of senators, was signed into law. This law helps address barriers to non-opioid pain management for those enrolled in Medicare, which will support efforts to stem the opioid epidemic in West Virginia and across the nation.

Opioid overdoses took the lives of over 70,000 Americans in 2021. The law expands patient and provider access to U.S. Food and Drug Administration (FDA) approved non-opioid pain management approaches in all outpatient surgical settings beginning in 2025 and requires a report to Congress on limitations, gaps, barriers to access, or deficits in Medicare coverage or reimbursement for therapeutic services.

“It is vital we continue to take steps to stop future addiction before it can begin,” Senator Capito said. “This law does exactly that by ensuring Medicare patients have access to non-opioid options, which will manage their post-surgical pain, while also helping them to avoid addiction and opioid misuse by others in their households. I’m confident this new law will make significant strides in preventing future addiction.”

BACKGROUND:

Prior to the NO PAIN Act being signed into law, hospitals received the same payment from Medicare regardless of whether a physician prescribed an opioid, or a non-opioid. As a result, hospitals relied on opioids, which are typically dispensed by a pharmacy after discharge at little or no cost to the hospital. The NOPAIN Act changes this policy by directing the Centers for Medicare & Medicaid Services (CMS) to provide separate Medicare reimbursement for non-opioid treatments used to manage pain in both the hospital outpatient department (HOPD) and the ambulatory surgery center (ASC) settings.

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