The Alternatives to PAIN Act seeks to enhance access to qualifying non-opioid pain management drugs under the Medicare Part D program. For plan years beginning on or after January 1, 2026, the bill mandates that the deductible will not apply to these specific drugs, and they must be placed on the lowest cost-sharing tier available. Furthermore, the legislation prohibits prescription drug plans and MA-PD plans from imposing certain utilization management requirements. Specifically, plans cannot require step therapy where an opioid must be used first, nor can they require prior authorization for these non-opioid pain management drugs. A qualifying non-opioid pain management drug is defined as an FDA-approved drug or biological product for acute pain that does not act on opioid receptors, lacks a therapeutically equivalent generic, and meets certain wholesale acquisition cost criteria.