119th Congress · introduced in the Senate · Feb 6, 2025
Alternatives to PAIN Act
Official title from Congress.gov
Latest action (Feb 6, 2025): Read twice and referred to the Committee on Finance.
View on Congress.govPolicy area: Health
Congressional Research Service summary, version: Introduced in Senate (Feb 6, 2025)
Alternatives to Prevent Addiction In the Nation Act or the Alternatives to PAIN Act
This bill reduces cost-sharing and prohibits the imposition of certain utilization requirements under the Medicare prescription drug benefit for certain non-opioid pain management drugs.
Specifically, the bill requires such drugs to be covered without a deductible and to be placed on the lowest cost-sharing tier (if any). The bill also prohibits the imposition of prior authorization requirements (i.e., requiring prior approval from a plan) or step therapy requirements (i.e., requiring the use of alternative drugs before a drug is covered under a plan) with respect to such drugs.
Includes amendment, cloture, and procedural votes. Each is labeled with its exact question; only a passage question is a vote to pass the bill.
No recorded roll calls on this bill in coverage.
Read twice and referred to the Committee on Finance.
Introduced in Senate
Actions from Congress.gov, newest first.
Drug therapy · Health care costs and insurance · Medicare · Prescription drugs
LD-2 reports whose issue descriptions explicitly cite this bill (bill type and number validated against Congress.gov records). A citation does not establish the client's position or any contact with a member.
Loading lobbying reportsCoverage: reports for 2025 onward, posted Jan 1, 2025 through Oct 24, 2026.
87 citations; showing the 25 most recently posted.
VERTEX PHARMACEUTICALS INCORPORATED · lobbying firm or registrant: CGCN GROUP, LLC
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 21, 2026 · issue area: Medicare/Medicaid
$50,000
Paid to lobbying firm
Access to innovative non-opioid medicines; Alternatives to PAIN, H.R. 1227; Alternatives to PAIN, S. 475.
Congress inferred from the report year; bill number matches Congress.gov records and the bill predates the report; no title was cited with it. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
VERTEX PHARMACEUTICALS INCORPORATED · lobbying firm or registrant: MARSHALL & POPP, LLC
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$60,000
Paid to lobbying firm
Issues related to pain management, including S.475/H.R. 1227 - Alternatives to PAIN Act. Issues related to prescription drug value, including implementation of the Inflation Reduction Act (PL 117-169), and impl…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
VERTEX PHARMACEUTICALS INCORPORATED · lobbying firm or registrant: AVENUE SOLUTIONS
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$60,000
Paid to lobbying firm
H.R. 1227/S. 475, Alternatives to PAIN Act and issues related to payment policies for non-opioid pain medication; Issues related to Most Favored Nation (MFN) drug pricing propo…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
AMERICAN ASSOCIATION OF NURSE PRACTITIONERS · lobbying firm or registrant: AMERICAN ASSOCIATION OF NURSE PRACTITIONERS
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Health Issues
$390,000
Spent on own lobbying
…Home Infusion Act S. 1874/H.R. 3593 - Title VIII Nursing Workforce Reauthorization Act of 2025 H.R. 1 - One Big Beautiful Bill Act [P.L. No. 119-21] H.R. 1227/S. 475 - the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 2199/S. 1173 - Restore Protections for Dialysis Patients Act (Restore Act…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
AMERICAN ASSOCIATION OF NURSE PRACTITIONERS · lobbying firm or registrant: AMERICAN ASSOCIATION OF NURSE PRACTITIONERS
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Medicare/Medicaid
$390,000
Spent on own lobbying
…NNECT for Health Act of 2025 H.R. 2172/S. 1058 - Preserving Patient Access to Home Infusion Act H.R. 1 - One Big Beautiful Bill Act [P.L. No. 119-21] H.R. 1227/S. 475 - the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 2531/S. 1232 - Workplace Violence Prevention for Health Care and Social S…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
AMERICAN PSYCHIATRIC ASSOCIATION · lobbying firm or registrant: AMERICAN PSYCHIATRIC ASSOCIATION
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Health Issues
$144,050
Spent on own lobbying
…ealth Care Provider Protection Reauthorization H.R. 593 - Strengthening Pathways to Health Professions Act H.R. 1153 - Rural America Health Corps Act H.R. 1227/S.475 - Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 1735/S.779 - EARLY Minds Act H.R. 1448 - PEER for Mental Health Act H.R. 1909…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
VERTEX PHARMACEUTICALS · lobbying firm or registrant: TIBER CREEK GROUP
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 20, 2026 · issue area: Health Issues
$60,000
Paid to lobbying firm
Issues related to drug pricing; Issues related to H.R. 1227/S. 475 - Alternatives to PAIN Act; Issues related to H.R. 1518 - New Era of Preventing End-Stage Kidney Disease Act.
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
VERTEX PHARMACEUTICALS INCORPORATED · lobbying firm or registrant: VERTEX PHARMACEUTICALS INCORPORATED
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 19, 2026 · issue area: Medicare/Medicaid
$1,100,000
Spent on own lobbying
Unmet medical need in acute pain; H.R. 1227/S. 475 - The Alternatives to PAIN Act; Implementation of Public Law No: 117-328 sec. 4135 NO PAIN Act; Medically necessary fertility treatments for patients undergoin…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
VERTEX PHARMACEUTICALS INCORPORATED · lobbying firm or registrant: CROSSROADS STRATEGIES, LLC
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 17, 2026 · issue area: Health Issues
$50,000
Paid to lobbying firm
General education about federal policies impacting pharmaceutical development, approval, and reimbursement. Education about non-opioid pain therapies.H.R.1227/S.475 Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act.
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
VERTEX PHARMACEUTICALS INCORPORATED · lobbying firm or registrant: CROSSROADS STRATEGIES, LLC
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 17, 2026 · issue area: Medicare/Medicaid
$50,000
Paid to lobbying firm
…maceutical development, approval, and reimbursement. Education about the importance of access to non-opioid pain therapies for Medicare beneficiaries. H.R.1227/S.475 Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act.
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
TRIS PHARMA, INC. AND ITS WHOLLY OWNED SUBSIDIARY ADNEURIS THERAPEUTICS · lobbying firm or registrant: AEGIS LLC
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 17, 2026 · issue area: Pharmacy
$50,000
Paid to lobbying firm
…c safety (distracted and impaired driving). Issues related to FDA approval. Patient access to non-opioid pain medicines. NO PAIN Act implementation. H.R.1227 / S.475: Alternatives to PAIN Act. Most-Favored Nation (MFN) International reference pricing. Make America Healthy Again (MAHA) Commission. Proposed regulations. Globa…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
AMERICAN SOCIETY OF ANESTHESIOLOGISTS · lobbying firm or registrant: AMERICAN SOCIETY OF ANESTHESIOLOGISTS
2026 Q3 report (Jul 1, 2026 – Sep 30, 2026) · posted Oct 13, 2026 · issue area: Health Issues
$270,000
Spent on own lobbying
…sion CMS: Federal Independent Dispute Resolution (IDR) Process, Batching H.R.27, HALT Fentanyl Act: fentanyl scheduling and registration requirements H.R. 1227/S.475, Alternatives to PAIN Act of 2025: access to non-opioid pain management options Pain Medicine Prescription Drug Abuse CDC Opioid Prescribing Guideline H.R. 359…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
VERTEX PHARMACEUTICALS INCORPORATED · lobbying firm or registrant: AVENUE SOLUTIONS
2026 Q2 report (Apr 1, 2026 – Jun 30, 2026) · posted Jul 20, 2026 · issue area: Medicare/Medicaid
$60,000
Paid to lobbying firm
H.R. 1227/S. 475, Alternatives to PAIN Act and issues related to payment policies for non-opioid pain medication; Issues related to Most Favored Nation (MFN) drug pricing propo…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
AMERICAN ASSOCIATION OF NURSE PRACTITIONERS · lobbying firm or registrant: AMERICAN ASSOCIATION OF NURSE PRACTITIONERS
2026 Q2 report (Apr 1, 2026 – Jun 30, 2026) · posted Jul 20, 2026 · issue area: Health Issues
$400,000
Spent on own lobbying
…Home Infusion Act S. 1874/H.R. 3593 - Title VIII Nursing Workforce Reauthorization Act of 2025 H.R. 1 - One Big Beautiful Bill Act [P.L. No. 119-21] H.R. 1227/S. 475 - the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 2199/S. 1173 - Restore Protections for Dialysis Patients Act (Restore Act…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
AMERICAN ASSOCIATION OF NURSE PRACTITIONERS · lobbying firm or registrant: AMERICAN ASSOCIATION OF NURSE PRACTITIONERS
2026 Q2 report (Apr 1, 2026 – Jun 30, 2026) · posted Jul 20, 2026 · issue area: Medicare/Medicaid
$400,000
Spent on own lobbying
…NNECT for Health Act of 2025 H.R. 2172/S. 1058 - Preserving Patient Access to Home Infusion Act H.R. 1 - One Big Beautiful Bill Act [P.L. No. 119-21] H.R. 1227/S. 475 - the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 2531/S. 1232 - Workplace Violence Prevention for Health Care and Social S…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
AMERICAN PSYCHIATRIC ASSOCIATION · lobbying firm or registrant: AMERICAN PSYCHIATRIC ASSOCIATION
2026 Q2 report (Apr 1, 2026 – Jun 30, 2026) · posted Jul 20, 2026 · issue area: Health Issues
$137,391
Spent on own lobbying
…athways to Health Professions Act H.R. 879/S.1640 - Medicare Patient Access and Practice Stabilization Act H.R. 1153 - Rural America Health Corps Act H.R. 1227/S.475 - Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act H.R. 1735/S.779 - EARLY Minds Act H.R. 1448 - PEER for Mental Health Act H.R. 1585…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
VERTEX PHARMACEUTICALS INCORPORATED · lobbying firm or registrant: CGCN GROUP, LLC
2026 Q2 report (Apr 1, 2026 – Jun 30, 2026) · posted Jul 19, 2026 · issue area: Medicare/Medicaid
$50,000
Paid to lobbying firm
Access to innovative non-opioid medicines; Alternatives to PAIN, H.R. 1227; Alternatives to PAIN, S. 475.
Congress inferred from the report year; bill number matches Congress.gov records and the bill predates the report; no title was cited with it. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
VERTEX PHARMACEUTICALS · lobbying firm or registrant: TIBER CREEK GROUP
2026 Q2 report (Apr 1, 2026 – Jun 30, 2026) · posted Jul 18, 2026 · issue area: Health Issues
$60,000
Paid to lobbying firm
Issues related to drug pricing; Issues related to H.R. 1227/S. 475 - Alternatives to PAIN Act; Issues related to H.R. 1518 - New Era of Preventing End-Stage Kidney Disease Act.
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
VERTEX PHARMACEUTICALS INCORPORATED · lobbying firm or registrant: CROSSROADS STRATEGIES, LLC
2026 Q2 report (Apr 1, 2026 – Jun 30, 2026) · posted Jul 17, 2026 · issue area: Health Issues
$50,000
Paid to lobbying firm
General education about federal policies impacting pharmaceutical development, approval, and reimbursement. Education about non-opioid pain therapies.H.R.1227/S.475 Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act.
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
VERTEX PHARMACEUTICALS INCORPORATED · lobbying firm or registrant: CROSSROADS STRATEGIES, LLC
2026 Q2 report (Apr 1, 2026 – Jun 30, 2026) · posted Jul 17, 2026 · issue area: Medicare/Medicaid
$50,000
Paid to lobbying firm
…maceutical development, approval, and reimbursement. Education about the importance of access to non-opioid pain therapies for Medicare beneficiaries. H.R.1227/S.475 Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act.
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
AMERICAN SOCIETY OF ANESTHESIOLOGISTS · lobbying firm or registrant: AMERICAN SOCIETY OF ANESTHESIOLOGISTS
2026 Q2 report (Apr 1, 2026 – Jun 30, 2026) · posted Jul 17, 2026 · issue area: Health Issues
$270,000
Spent on own lobbying
…sion CMS: Federal Independent Dispute Resolution (IDR) Process, Batching H.R.27, HALT Fentanyl Act: fentanyl scheduling and registration requirements H.R. 1227/S.475, Alternatives to PAIN Act of 2025: access to non-opioid pain management options Pain Medicine Prescription Drug Abuse CDC Opioid Prescribing Guideline H.R. 359…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
VERTEX PHARMACEUTICALS INCORPORATED · lobbying firm or registrant: VERTEX PHARMACEUTICALS INCORPORATED
2026 Q2 report (Apr 1, 2026 – Jun 30, 2026) · posted Jul 16, 2026 · issue area: Medicare/Medicaid
$1,200,000
Spent on own lobbying
Unmet medical need in acute pain; H.R. 1227/S. 475 - The Alternatives to PAIN Act; Implementation of Public Law No: 117-328 sec. 4135 NO PAIN Act; Medically necessary fertility treatments for patients undergoin…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
VERTEX PHARMACEUTICALS INCORPORATED · lobbying firm or registrant: MARSHALL & POPP, LLC
2026 Q2 report (Apr 1, 2026 – Jun 30, 2026) · posted Jul 9, 2026 · issue area: Medicare/Medicaid
$60,000
Paid to lobbying firm
Issues related to pain management, including S.475/H.R. 1227 - Alternatives to PAIN Act. Issues related to prescription drug value, including implementation of the Inflation Reduction Act (PL 117-169), and impl…
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
TRIS PHARMA, INC. AND ITS WHOLLY OWNED SUBSIDIARY ADNEURIS THERAPEUTICS · lobbying firm or registrant: AEGIS LLC
2026 Q2 report (Apr 1, 2026 – Jun 30, 2026) · posted Jul 2, 2026 · issue area: Pharmacy
$50,000
Paid to lobbying firm
…c safety (distracted and impaired driving). Issues related to FDA approval. Patient access to non-opioid pain medicines. NO PAIN Act implementation. H.R.1227 / S.475: Alternatives to PAIN Act. Most-Favored Nation (MFN) International reference pricing. Make America Healthy Again (MAHA) Commission.
Congress inferred from the report year; bill number and the title cited with it match Congress.gov records, and the bill predates the report. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing
VERTEX PHARMACEUTICALS INCORPORATED · lobbying firm or registrant: CGCN GROUP, LLC
2026 Q1 report (Jan 1, 2026 – Mar 31, 2026) · posted Apr 20, 2026 · issue area: Medicare/Medicaid
$80,000
Paid to lobbying firm
Access to innovative non-opioid medicines; Alternatives to PAIN, H.R. 1227; Alternatives to PAIN, S. 475.
Congress inferred from the report year; bill number matches Congress.gov records and the bill predates the report; no title was cited with it. The amount is lobbying spending for every issue on this report, not this bill alone, and none of it is paid to any member of Congress. View filing