H.R. 10254
MORE Savings Act
Sponsor: Madeleine Dean · 0 cosponsors
Official summary
Written by the Congressional Research Service.
Maximizing Opioid Recovery Emergency Savings Act or the MORE Savings Act
This bill modifies coverage of opioid treatments and recovery support services under Medicare, Medicaid, and private health insurance.
Specifically, the bill requires the Center for Medicare and Medicaid Innovation to test a model in which specified opioid treatments and recovery support services are provided under Medicare without cost-sharing (e.g., coinsurance, copayments, and deductibles).
The bill also allows state Medicaid programs to cover recovery support services as part of medication-assisted treatment (MAT) and increases the applicable Federal Medical Assistance Percentage for MAT.
Additionally, beginning in 2027, private health insurers must cover specified opioid treatments and MAT-associated recovery support services without cost-sharing.
Text of the bill
(a) In general
(1) PHSA. Part D of title XXVII of the Public Health Service Act (42 U.S.C. 300gg–111 et seq.) is amended by adding at the end the following:
2799A–11. Coverage of opioid treatments. A group health plan and a health insurance issuer offering group or individual health insurance coverage shall, at a minimum, with respect to a participant, beneficiary, or enrollee in the plan or coverage, provide coverage for and shall not impose any cost-sharing requirements for—
(1) prescription drugs for the treatment of opioid use disorders or to reverse overdose;
(2) behavioral health services for the treatment of opioid use disorders, including treatment of opioid use disorders in non-hospital residential facilities licensed to provide such treatment; or
(3) community recovery support services that are provided in conjunction with, where appropriate, medication-assisted treatment for an opioid use disorder, such as peer counseling and transportation, to support the participant, beneficiary, or enrollee in maintaining a healthy lifestyle following opioid misuse treatment.
(2) ERISA
(A) In general. Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.) is amended by adding at the end the following:
726. Coverage of opioid treatments. A group health plan and a health insurance issuer offering group health insurance coverage shall, at a minimum, with respect to a participant or beneficiary in the plan or coverage, provide coverage for and shall not impose any cost-sharing requirements for—
(1) prescription drugs for the treatment of opioid use disorders or to reverse overdose;
(2) behavioral health services for the treatment of opioid use disorders, including treatment of opioid use disorders in non-hospital residential facilities licensed to provide such treatment; or
(3) community recovery support services that are provided in conjunction with, where appropriate, medication-assisted treatment for an opioid use disorder, such as peer counseling and transportation, to support the participant or beneficiary in maintaining a healthy lifestyle following opioid misuse treatment.
(B) Clerical amendment. The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001 et seq.) is amended by inserting after the item relating to section 725 the following new item:
Sec. 726. Coverage of opioid treatments.
(3) IRC
(A) In general. Chapter 100 of the Internal Revenue Code of 1986 is amended by adding at the end the following:
9826. Coverage of opioid treatments. A group health plan shall, at a minimum, with respect to a participant or beneficiary in the plan, provide coverage for and shall not impose any cost-sharing requirements for—
(1) prescription drugs for the treatment of opioid use disorders or to reverse overdose;
(2) behavioral health services for the treatment of opioid use disorders, including treatment of opioid use disorders in non-hospital residential facilities licensed to provide such treatment; or
(3) community recovery support services that are provided in conjunction with, where appropriate, medication-assisted treatment for an opioid use disorder, such as peer counseling and transportation, to support the participant or beneficiary in maintaining a healthy lifestyle following opioid misuse treatment.
(B) Clerical amendment. The table of sections for subchapter B of chapter 100 of the Internal Revenue Code of 1986 is amended by adding at the end the following new item: Sec. 9826. Coverage of opioid treatments..
(b) Effective date. The amendments made by subsection (a) shall apply with respect to plan years beginning on or after January 1, 2027.