The opioid crisis in America has touched countless lives, delivering devastating blows to families and communities. This overwhelming health crisis affects over 9 million people of all ages and has had a significant impact on patients seeking pain management.[1] In response to this epidemic, lawmakers are prioritizing access to safer, more effective pain management alternatives.
The Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act is a groundbreaking step forward in this mission. Set to take effect in 2025, this legislation expands excess to non-opioid pain treatment, particularly for Medicare and Medicaid patients. The NOPAIN ACT empowers healthcare providers and patients to utilize pain management alternatives to opioids by providing reimbursement for them in surgery centers and hospitals.[2]
The No Pain Act 2025 Explained
According to S.586 -The NOPAIN Act aims to reduce the reliance on opioids by increasing access to non-opioid pain treatments for Medicare and Medicaid (CMS) beneficiaries, including seniors. It ensures that non-opioid therapies are reimbursed separately under federal healthcare programs.
Before the No Pain Act, insurance companies reimbursed the same amount regardless of whether an opioid or non-opioid was prescribed. As a result, many hospitals chose lower-cost opioids rather than exploring non-opioid alternatives.[3] With separate billing codes, the new law encourages healthcare providers to offer non-opioid treatment options to their patients. This coverage change helps avoid addiction and misuse by others who may have access to the pain medications.
The act applies to pain management strategies used during surgical, post-surgical, and outpatient care. It also simplifies access to innovative therapies, giving patients a broader range of choices for managing their pain. The NOPAIN ACT will also help identify limitations, gaps and barriers to access for restorative therapies, behavioral approaches and complementary and integrative treatments.[4]
The NOPAIN ACT Timeline
The No Pain Act was initially passed in 2022 and has since been refined in recent years…
- 2018: Initial discussions about reducing opioid dependency spark legislative interest.[5]
- 2021: The NOPAIN Act is introduced to Congress.[4]
- 2022: No Pain Act signed into law.[2]
- 2025: Full CMS https://www.cms.gov/ coverage for qualifying non-opioid pain management options go into effect January 1st, 2025.[2]
Reimbursed Non-Opioid Alternatives
According to the NO PAIN ACT FAQs, these are some of the alternative treatments that are prioritized as reimbursable alternatives to opioids:
- Prescription & Over-the-Counter Medications
- Non-opioid analgesics (e.g., Exparel, Omidria, Dextenza)
- NSAIDs (e.g., ibuprofen, naproxen, acetaminophen)
- Topical pain relievers (e.g., capsaicin, lidocaine patches)
- Non-Pharmacological Therapies
- Physical therapy
- Cognitive behavioral therapy (CBT)
- Acupuncture
- Chiropractic care
- Massage
- Pain Control Methods
- Nerve blocks
- Joint injections
- Pain pumps
- Epidural steroid injections
- Trigger point injections
- Neuromodulation devices
- Radiofrequency ablation
The NOPAIN Act enables providers to offer diverse and effective opioid alternative pain management solutions by ensuring treatment coverage. This is not an exhaustive list of covered treatments; the options may change as new therapies are approved.
Why is it Important to Provide Non-Opioid Options?
Opioids can be effective for severe pain and will still be covered by CMS programs, but they come with serious risks like addiction, overdose, and increased pain sensitivity over time. They may also cause side effects such as nausea, constipation, and dizziness, along with long-term issues like depression and hormonal changes. Expanding covered non-opioid pain treatment options helps patients manage their pain safely while avoiding these risks.
Speak with a Pain Specialist About Safe, Effective, and Flexible Pain Management
Non-opioid pharmaceuticals will now be covered separately, encouraging healthcare professionals to prescribe them more often. Prescription opioids are still covered for patients whose pain isn’t relieved by the alternatives, but the act provides separate reimbursement options.
The NOPAIN Act expands access to safer, non-opioid pain relief, including evidence-based therapies and minimally invasive procedures. Talk to your pain specialist about these best practices that help reduce opioid use. With the NOPAIN Act, better pain management is accessible to more Americans.
Resources:
- NIH HEAL Initiative | The Opioid Crisis. National Institutes of Health – NIH HEAL Initiative [Internet]. Published July 20, 2023. Accessed December 11, 2024. Available from: https://heal.nih.gov/about/opioid-crisis
- Expand Access to Safe, Non-Opioid Options Now. Voices for Non-Opioid Choices [Internet]. Accessed December 11, 2024. Available from: https://nonopioidchoices.org/advocacy/nopain-act-implementation/
- In Case You Missed It: Capito’s NO PAIN Act to Address Opioid Crisis Signed Into Law. U.S. Senator Shelley Moore Capito of West Virginia [Internet]. Accessed December 11, 2024. Available from: https://www.capito.senate.gov/news/press-releases/in-case-you-missed-itcapitos-no-pain-act-to-address-opioid-crisis-signed-into-law
- Moore S. Text – S.586 – 117th Congress (2021-2022): NOPAIN Act. Congress.gov [Internet]. Published 2021. Accessed December 11, 2024. Available from: https://www.congress.gov/bill/117th-congress/senate-bill/586/text
- The Opioid Crisis Response Act of 2018. U.S. Senate Committee on Health, Education, Labor and Pensions [Internet]. Accessed December 11, 2024. Available from: https://www.help.senate.gov/imo/media/doc/The%20Opioid%20Crisis%20Response%20Act%20of%202018%20summary.pdf
