NOPAIN for Veterans Act

Bill Number

H.R. 4509

Origin Chamber

House

Congress

119th Congress, Session 1

Policy Area

Armed Forces and National Security

Status

Introduced

Latest Action

2026-01-13: Subcommittee Hearings Held

Last Updated

2026-06-09T08:06:22Z

AI-Generated Summary

Summary of H.R. 4509: NOPAIN for Veterans Act

Purpose

This bill aims to improve access to non-opioid pain management options for veterans by requiring the Department of Veterans Affairs (VA) to include certain FDA-approved non-opioid drugs and biological products in its national formulary and drug standardization list. It seeks to promote safer pain relief alternatives amid concerns over opioid use.

Key Provisions

• Definition of Non-Opioid Products: Adds a definition for "non-opioid pain management drug or biological product" as any drug or biological product approved, granted, or cleared by the Food and Drug Administration (FDA) to reduce postoperative pain or provide postsurgical or regional pain relief (analgesia) without interacting with the body's opioid receptors.
• Inclusion in VA Formulary: Mandates that the VA Secretary include these products in the VA's national formulary (a list of approved medications) no later than one year after they become eligible for temporary additional payment under Medicare's outpatient prospective payment system (section 1833(t)(16)(G) of the Social Security Act) or for separate payment under relevant federal regulations (42 CFR 416.174 or successor).
• Drug Standardization: Requires these products to also be added to the VA's drug standardization list, which helps ensure consistent availability and pricing across VA facilities.
• Funding Limitation: Prohibits the use of funds from the Cost of War Toxic Exposures Fund (established under VA law to address toxic exposure-related claims) to implement these changes.
• Implementation Timeline: The VA must enact these amendments within 90 days of the bill's passage.

Significant Changes to Existing Law

• Amends section 8125 of title 38, United States Code (which governs the VA's national formulary and drug standardization processes) by:
• Inserting the new definition into subsection (d) and redesignating it as subsection (e).
• Adding a new subsection (d) with the inclusion requirements.
• This introduces mandatory timelines and criteria for adding non-opioid pain products, shifting from discretionary to required inclusion based on FDA approval and Medicare eligibility, without altering broader formulary management rules.

Potential Impacts

• On Government Agencies: The VA will need to update its formulary processes promptly, potentially increasing administrative workload and costs for reviewing and incorporating new products. It ensures alignment with Medicare payment structures but restricts funding sources, possibly requiring reallocation from general VA budgets.
• On Citizens (Veterans): Veterans receiving care through the VA will gain faster access to non-opioid pain relief options, which could reduce reliance on opioids, lower addiction risks, and improve pain management outcomes, especially for postoperative or chronic pain.
• On International Relations: No direct impacts, as the bill focuses on domestic VA operations and U.S.-specific regulations like FDA approvals and Medicare.

Main Stakeholders Affected

• Veterans: Primary beneficiaries, particularly those needing pain management for service-related injuries or surgeries.
• Department of Veterans Affairs: Responsible for implementation, formulary updates, and ensuring compliance.
• Pharmaceutical and Biotechnology Companies: Producers of qualifying non-opioid products may see increased demand and easier market access within the VA system.
• Congress and Taxpayers: Involved in oversight of VA funding and the prohibition on using specific funds, affecting budget priorities.

Notable Legal, Constitutional, or Political Implications

• Legal: Strengthens VA obligations under federal drug management laws by tying inclusions to objective FDA and Medicare criteria, potentially reducing delays in adopting innovative treatments. The 90-day implementation deadline enforces accountability but could face challenges if product eligibility surges.
• Constitutional: No apparent issues; the bill operates within Congress's authority to regulate federal agencies like the VA and manage veterans' benefits under Article I.
• Political: Bipartisan sponsorship (from both parties) highlights cross-aisle support for addressing the opioid crisis in veteran care. It promotes public health goals without mandating broad policy shifts, though it may influence future debates on VA funding and non-opioid innovation incentives.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Rep. Landsman, Greg [D-OH-1]

Cosponsors (32)

Rep. Van Orden, Derrick [R-WI-3], Rep. Pappas, Chris [D-NH-1], Rep. Bergman, Jack [R-MI-1], Rep. Sewell, Terri A. [D-AL-7], Rep. Hamadeh, Abraham J. [R-AZ-8], Rep. Khanna, Ro [D-CA-17], Rep. Stanton, Greg [D-AZ-4], Rep. Suozzi, Thomas R. [D-NY-3], Rep. Craig, Angie [D-MN-2], Rep. Pettersen, Brittany [D-CO-7], Rep. Morrison, Kelly [D-MN-3], Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. McBride, Sarah [D-DE-At Large], Rep. Kennedy, Timothy M. [D-NY-26], Rep. Ciscomani, Juan [R-AZ-6], Rep. DelBene, Suzan K. [D-WA-1], Rep. Schmidt, Derek [R-KS-2], Rep. Harrigan, Pat [R-NC-10], Rep. Thanedar, Shri [D-MI-13], Rep. Morelle, Joseph D. [D-NY-25], Rep. Vindman, Eugene Simon [D-VA-7], Rep. Kiggans, Jennifer A. [R-VA-2], Rep. Tran, Derek [D-CA-45], Rep. Goodlander, Maggie [D-NH-2], Rep. Fitzpatrick, Brian K. [R-PA-1], Rep. Bynum, Janelle S. [D-OR-5], Rep. Keating, William R. [D-MA-9], Rep. Beatty, Joyce [D-OH-3], Rep. Williams, Nikema [D-GA-5], Rep. Budzinski, Nikki [D-IL-13], Rep. Balint, Becca [D-VT-At Large], Rep. Cleaver, Emanuel [D-MO-5]

Recent Actions

• 2026-01-13: Subcommittee Hearings Held
• 2025-12-19: Referred to the Subcommittee on Health.
• 2025-07-17: Referred to the House Committee on Veterans' Affairs.
• 2025-07-17: Introduced in House
• 2025-07-17: Introduced in House

Bill Versions

• NOPAIN for Veterans Act — issued 2025-07-17 — PDF (3 pages)