Major Funding Boost and Insurance Reforms for Opioid Crisis Treatment.
This Act significantly increases federal funding for substance use disorder treatment, prevention, and community support programs through 2033. It introduces critical health insurance reforms, mandating zero cost-sharing for opioid overdose reversal agents (like naloxone) and prohibiting prior authorization requirements for Medication-Assisted Treatment (MAT) under Medicaid. The bill also boosts payment rates for behavioral health providers in Medicaid.
Key points
Opioid overdose reversal agents must be covered with zero cost-sharing (no copay or deductible) by most health plans and Medicare starting in 2025.
Medicaid is prohibited from imposing prior authorization requirements on Medication-Assisted Treatment (MAT), ensuring easier access to life-saving therapies.
Billions of dollars are reauthorized for State Opioid Response Grants, first responder training, residential programs for pregnant women, and Drug Court programs.
Medicaid payment rates are increased for mental and behavioral health providers treating substance use disorders, encouraging more professionals to offer these services.
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