MORE Savings Act

II 116TH CONGRESS 1ST SESSION S. 1424 To promote affordable access to evidence-based opioid treatments under the Medicare program and require coverage of medication assisted treatment for opioid use disorders, opioid overdose reversal medications, and recov- ery support services by health plans without cost-sharing requirements. IN THE SENATE OF THE UNITED STATES MAY 13, 2019 Mr. CASEY (for himself, Mrs. SHAHEEN, and Ms. KLOBUCHAR) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To promote affordable access to evidence-based opioid treat- ments under the Medicare program and require coverage of medication assisted treatment for opioid use disorders, opioid overdose reversal medications, and recovery sup- port services by health plans without cost-sharing re- quirements. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Maximizing Opioid Re- 4 covery Emergency Savings Act’’ or the ‘‘MORE Savings 5 Act’’. 6 VerDate Sep 11 2014 19:06 May 21, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1424.IS S1424 pamtmann on DSKBFK8HB2PROD with BILLS 2 •S 1424 IS SEC. 2. TESTING OF ELIMINATION OF MEDICARE COST- 1 SHARING FOR EVIDENCE-BASED OPIOID 2 TREATMENTS. 3 Section 1115A(b)(2) of the Social Security Act (42 4 U.S.C. 1315a(b)(2)) is amended— 5 (1) in subparagraph (A), in the last sentence, 6 by inserting ‘‘, and shall include the model described 7 in subparagraph (D) (which shall be implemented by 8 not later than six months after the date of the en- 9 actment of the Maximizing Opioid Recovery Emer- 10 gency Savings Act)’’ before the period at the end; 11 and 12 (2) by adding at the end the following new sub- 13 paragraph: 14 ‘‘(D) AFFORDABLE ACCESS TO EVIDENCE- 15 BASED OPIOID TREATMENTS.— 16 ‘‘(i) IN GENERAL.—The model de- 17 scribed in this subparagraph is a model 18 that seeks to provide affordable access to 19 evidence-based opioid treatments and re- 20 covery support services by eliminating coin- 21 surance, copayments, and deductibles oth- 22 erwise applicable under parts B and D of 23 title XVIII (including as such parts are ap- 24 plied under part C of such title) for the 25 VerDate Sep 11 2014 19:06 May 21, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1424.IS S1424 pamtmann on DSKBFK8HB2PROD with BILLS 3 •S 1424 IS following items and services that are other- 1 wise covered under such parts: 2 ‘‘(I) Drugs and biologicals pre- 3 scribed or furnished to treat opioid 4 use disorders or reverse overdose. 5 ‘‘(II) Behavioral health services 6 furnished for the treatment of opioid 7 use disorders. 8 ‘‘(III) Recovery support services 9 to maintain a healthy lifestyle fol- 10 lowing opioid misuse treatment, such 11 as peer counseling and transportation. 12 ‘‘(ii) SELECTION OF SITES.—The CMI 13 shall select 15 States in which to conduct 14 the model under this subparagraph. A 15 State shall meet each of the following cri- 16 teria in order to be selected under the pre- 17 ceding sentence: 18 ‘‘(I) The State has a high pro- 19 portion of Medicare beneficiaries. 20 ‘‘(II) The State has a high rate 21 of overdose deaths due to opioids. 22 ‘‘(III) The State has a significant 23 percentage of rural areas. 24 VerDate Sep 11 2014 19:06 May 21, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1424.IS S1424 pamtmann on DSKBFK8HB2PROD with BILLS 4 •S 1424 IS ‘‘(iii) TERMINATION AND MODIFICA- 1 TION PROVISION NOT APPLICABLE FOR 2 FIRST FIVE YEARS OF THE MODEL.—The 3 provisions of paragraph (3)(B) shall apply 4 to the model under this subparagraph be- 5 ginning on the date that is five years after 6 such model is implemented, but shall not 7 apply to such model prior to such date.’’. 8 SEC. 3. COVERAGE OF OPIOID TREATMENTS. 9 Title XXVII of the Public Health Service Act is 10 amended by inserting after section 2719A (42 U.S.C. 11 300gg–19a) the following: 12 ‘‘SEC. 2720. COVERAGE OF OPIOID TREATMENTS. 13 ‘‘A group health plan and a health insurance issuer 14 offering group or individual health insurance coverage 15 shall, at a minimum, provide coverage for and shall not 16 impose any cost-sharing requirements for— 17 ‘‘(1) prescription drugs for the treatment of 18 opioid use disorders or to reverse overdose; 19 ‘‘(2) behavioral health services for the treat- 20 ment of opioid use disorders; or 21 ‘‘(3) recovery support services that are provided 22 in conjunction with medication-assisted treatment 23 for an opioid use disorder, such as peer counseling 24 and transportation, to support the enrollee in main- 25 VerDate Sep 11 2014 19:06 May 21, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1424.IS S1424 pamtmann on DSKBFK8HB2PROD with BILLS 5 •S 1424 IS taining a healthy lifestyle following opioid misuse 1 treatment.’’. 2 SEC. 4. ENHANCED FEDERAL MATCH FOR MEDICATION-AS- 3 SISTED TREATMENT AND RECOVERY SUP- 4 PORT SERVICES UNDER MEDICAID. 5 (a) IN GENERAL.—Section 1905(b) of the Social Se- 6 curity Act (42 U.S.C. 1396d(b)) is amended by adding 7 at the end the following: ‘‘Notwithstanding the first sen- 8 tence of this subsection, the Federal medical assistance 9 percentage shall be 90 percent with respect to amounts 10 expended during the period described in subsection (a)(29) 11 by a State that is one of the 50 States or the District 12 of Columbia as medical assistance for medication-assisted 13 treatment (as defined in subsection (ee)(1)).’’. 14 (b) STATE OPTION TO PROVIDE RECOVERY SUP- 15 PORT SERVICES AS PART OF MEDICATION-ASSISTED 16 TREATMENT.—Section 1905(ee)(1) of the Social Security 17 Act (42 U.S.C. 1396d(ee)(1)) is amended— 18 (1) in subparagraph (A), by striking ‘‘; and’’ 19 and inserting a semicolon; 20 (2) in subparagraph (B), by striking the period 21 at the end and inserting ‘‘; and’’; and 22 (3) by adding at the end the following new sub- 23 paragraph: 24 VerDate Sep 11 2014 19:06 May 21, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1424.IS S1424 pamtmann on DSKBFK8HB2PROD with BILLS 6 •S 1424 IS ‘‘(C) at the option of a State, includes re- 1 covery support services, such as peer counseling 2 and transportation, that are provided to an in- 3 dividual in conjunction with the provision of 4 such drugs and biological products to support 5 the individual in maintaining a healthy lifestyle 6 following opioid misuse treatment.’’. 7 Æ VerDate Sep 11 2014 19:06 May 21, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\S1424.IS S1424 pamtmann on DSKBFK8HB2PROD with BILLS