MORE Savings Act

I 116TH CONGRESS 2D SESSION H. R. 7627 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 HOUSE OF REPRESENTATIVES JULY 16, 2020 Ms. DEAN introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the juris- diction of the committee concerned 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 VerDate Sep 11 2014 05:36 Aug 05, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H7627.IH H7627 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 7627 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Maximizing Opioid Re- 2 covery Emergency Savings Act’’ or the ‘‘MORE Savings 3 Act’’. 4 SEC. 2. TESTING OF ELIMINATION OF MEDICARE COST- 5 SHARING FOR EVIDENCE-BASED OPIOID 6 TREATMENTS. 7 Section 1115A(b)(2) of the Social Security Act (42 8 U.S.C. 1315a(b)(2)) is amended— 9 (1) in subparagraph (A), in the last sentence, 10 by inserting ‘‘, and shall include the model described 11 in subparagraph (D) (which shall be implemented by 12 not later than six months after the date of the en- 13 actment of the Maximizing Opioid Recovery Emer- 14 gency Savings Act)’’ before the period at the end; 15 and 16 (2) by adding at the end the following new sub- 17 paragraph: 18 ‘‘(D) AFFORDABLE ACCESS TO EVIDENCE- 19 BASED OPIOID TREATMENTS.— 20 ‘‘(i) IN GENERAL.—The model de- 21 scribed in this subparagraph is a model 22 that seeks to provide affordable access to 23 evidence-based opioid treatments and re- 24 covery support services by eliminating coin- 25 surance, copayments, and deductibles oth- 26 VerDate Sep 11 2014 05:36 Aug 05, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H7627.IH H7627 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 7627 IH erwise applicable under parts B and D of 1 title XVIII (including as such parts are ap- 2 plied under part C of such title) for the 3 following items and services that are other- 4 wise covered under such parts: 5 ‘‘(I) Drugs and biologicals pre- 6 scribed or furnished to treat opioid 7 use disorders or reverse overdose. 8 ‘‘(II) Behavioral health services 9 furnished for the treatment of opioid 10 use disorders. 11 ‘‘(III) Recovery support services 12 to maintain a healthy lifestyle fol- 13 lowing opioid misuse treatment, such 14 as peer counseling and transportation. 15 ‘‘(ii) SELECTION OF SITES.—The CMI 16 shall select 15 States in which to conduct 17 the model under this subparagraph. A 18 State shall meet each of the following cri- 19 teria in order to be selected under the pre- 20 ceding sentence: 21 ‘‘(I) The State has a high pro- 22 portion of Medicare beneficiaries. 23 ‘‘(II) The State has a high rate 24 of overdose deaths due to opioids. 25 VerDate Sep 11 2014 05:36 Aug 05, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H7627.IH H7627 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 7627 IH ‘‘(III) The State has a significant 1 percentage of rural areas. 2 ‘‘(iii) TERMINATION AND MODIFICA- 3 TION PROVISION NOT APPLICABLE FOR 4 FIRST FIVE YEARS OF THE MODEL.—The 5 provisions of paragraph (3)(B) shall apply 6 to the model under this subparagraph be- 7 ginning on the date that is five years after 8 such model is implemented, but shall not 9 apply to such model prior to such date.’’. 10 SEC. 3. COVERAGE OF OPIOID TREATMENTS. 11 Title XXVII of the Public Health Service Act is 12 amended by inserting after section 2719A (42 U.S.C. 13 300gg–19a) the following: 14 ‘‘SEC. 2720. COVERAGE OF OPIOID TREATMENTS. 15 ‘‘A group health plan and a health insurance issuer 16 offering group or individual health insurance coverage 17 shall, at a minimum, provide coverage for and shall not 18 impose any cost-sharing requirements for— 19 ‘‘(1) prescription drugs for the treatment of 20 opioid use disorders or to reverse overdose; 21 ‘‘(2) behavioral health services for the treat- 22 ment of opioid use disorders; or 23 ‘‘(3) recovery support services that are provided 24 in conjunction with medication-assisted treatment 25 VerDate Sep 11 2014 05:36 Aug 05, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H7627.IH H7627 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 7627 IH for an opioid use disorder, such as peer counseling 1 and transportation, to support the enrollee in main- 2 taining a healthy lifestyle following opioid misuse 3 treatment.’’. 4 SEC. 4. ENHANCED FEDERAL MATCH FOR MEDICATION-AS- 5 SISTED TREATMENT AND RECOVERY SUP- 6 PORT SERVICES UNDER MEDICAID. 7 (a) IN GENERAL.—Section 1905(b) of the Social Se- 8 curity Act (42 U.S.C. 1396d(b)) is amended by adding 9 at the end the following: ‘‘Notwithstanding the first sen- 10 tence of this subsection, the Federal medical assistance 11 percentage shall be 90 percent with respect to amounts 12 expended during the period described in subsection (a)(29) 13 by a State that is one of the 50 States or the District 14 of Columbia as medical assistance for medication-assisted 15 treatment (as defined in subsection (ee)(1)).’’. 16 (b) STATE OPTION TO PROVIDE RECOVERY SUP- 17 PORT SERVICES AS PART OF MEDICATION-ASSISTED 18 TREATMENT.—Section 1905(ee)(1) of the Social Security 19 Act (42 U.S.C. 1396d(ee)(1)) is amended— 20 (1) in subparagraph (A), by striking ‘‘; and’’ 21 and inserting a semicolon; 22 (2) in subparagraph (B), by striking the period 23 at the end and inserting ‘‘; and’’; and 24 VerDate Sep 11 2014 05:36 Aug 05, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H7627.IH H7627 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 7627 IH (3) by adding at the end the following new sub- 1 paragraph: 2 ‘‘(C) at the option of a State, includes re- 3 covery support services, such as peer counseling 4 and transportation, that are provided to an in- 5 dividual in conjunction with the provision of 6 such drugs and biological products to support 7 the individual in maintaining a healthy lifestyle 8 following opioid misuse treatment.’’. 9 Æ VerDate Sep 11 2014 05:36 Aug 05, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\H7627.IH H7627 kjohnson on DSK79L0C42PROD with BILLS