I 
119TH CONGRESS 
1ST SESSION H. R. 5120 
To amend titles XVIII and XIX of the Social Security Act and title 10, 
United States Code, to provide no-cost coverage for the preventive dis-
tribution of opioid overdose reversal drugs. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 3, 2025 
Ms. PETTERSEN (for herself and Mrs. KIGGANS of Virginia) introduced the 
following bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committees on Ways and Means, and 
Armed Services, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned 
A BILL 
To amend titles XVIII and XIX of the Social Security Act 
and title 10, United States Code, to provide no-cost 
coverage for the preventive distribution of opioid overdose 
reversal drugs. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Hospitals As Naloxone 
Distribution Sites Act’’ or the ‘‘HANDS Act’’. 
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SEC. 2. NO-COST COVERAGE OF PREVENTIVE OPIOID OVER-
DOSE REVERSAL DRUGS. 
(a) COVERAGE UNDER MEDICARE.— 
(1) COVERAGE.—Section 1861(s)(2) of the So-
cial Security Act (42 U.S.C. 1395x(s)(2)) is amend-
ed— 
(A) in subparagraph (JJ), by adding 
‘‘and’’ after the semicolon at the end; and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(KK) a preventive opioid overdose reversal 
drug (as defined in subsection (nnn)) furnished on 
or after January 1, 2026;’’. 
(2) PREVENTIVE OPIOID OVERDOSE REVERSAL 
DRUG DEFINED.—Section 1861 of the Social Secu-
rity Act (42 U.S.C. 1395x) is amended by adding at 
the end the following new subsection: 
‘‘(nnn) PREVENTIVE OPIOID OVERDOSE REVERSAL 
DRUG.—The term ‘preventive opioid overdose reversal 
drug’ means an opioid overdose reversal drug, which may 
be either intranasal or intramuscular, that is furnished by 
a physician, nurse practitioner, physician assistant, or 
other attending clinical personnel (as determined by the 
Secretary by regulation) to an individual who is an inpa-
tient of a hospital, critical access hospital, or rural emer-
gency hospital, or is a patient of the emergency depart-
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ment of such a hospital or an ambulatory surgical center, 
but only if— 
‘‘(1) such physician, nurse practitioner, physi-
cian assistant, or attending clinical professional de-
termines that such individual is at risk for an opioid 
overdose; and 
‘‘(2) such drug is furnished at the time such in-
dividual is discharged from the hospital or leaves the 
emergency department or ambulatory surgical cen-
ter, as the case may be, together with instructions 
for the administration of such drug.’’. 
(3) PROHIBITION OF COST SHARING.—Section 
1833 of the Social Security Act (42 U.S.C. 1395l) 
is amended— 
(A) in subsection (a)(1)— 
(i) in subparagraph (S)(i), by striking 
‘‘subparagraph (EE),’’ and inserting ‘‘sub-
paragraphs (EE) and (II),’’; 
(ii) in subparagraph (GG), by striking 
‘‘and’’ at the end; and 
(iii) by inserting ‘‘, and (II) with re-
spect to a preventive opioid overdose rever-
sal drug (as defined in section 1861(nnn)) 
furnished on or after January 1, 2026, the 
amounts paid shall be 100 percent of the 
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lesser of the actual charges for such drug 
or the amount determined under section 
1842(o)’’ before the semicolon at the end; 
and 
(B) in subsection (b)— 
(i) by striking ‘‘, and (13)’’ and in-
serting ‘‘(13)’’; and 
(ii) by striking ‘‘section 1861(n)..’’ 
and inserting ‘‘section 1861(n), and (14) 
such deductible shall not apply with re-
spect to a preventive opioid reversal drug 
(as defined in section 1861(nnn)) fur-
nished on or after January 1, 2026.’’. 
(4) PROHIBITION OF COST SHARING FOR MEDI-
CARE ADVANTAGE PLANS.—Section 1852(a)(1)(B) of 
the Social Security Act (42 U.S.C. 1395w– 
22(a)(1)(B)) is amended— 
(A) in clause (iv)— 
(i) by redesignating subclause (VIII) 
as subclause (IX); and 
(ii) by inserting after subclause (VII) 
the following new subclause: 
‘‘(VIII) A preventive opioid rever-
sal drug (as defined in section 
1861(nnn)).’’; and 
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(B) in clause (v), by striking ‘‘and (VI)’’ 
and inserting ‘‘(VI), and (VIII)’’. 
(b) COVERAGE UNDER MEDICAID.— 
(1) MANDATORY COVERAGE.— 
(A) IN GENERAL.—Section 1902(a)(10)(A) 
of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1396a(a)(10)(A)) is amended by striking ‘‘and 
(30)’’ and inserting ‘‘(30), and (32)’’. 
(B) ALTERNATIVE BENEFIT PLANS.—Sec-
tion 1937(b) of the Social Security Act (42 
U.S.C. 1396u–7(b)) is amended by adding at 
the end the following new paragraph: 
‘‘(9) PREVENTIVE OPIOID OVERDOSE REVERSAL 
DRUGS.—Notwithstanding the previous provisions of 
this section, a State may not provide for medical as-
sistance through enrollment of an individual with 
benchmark coverage or benchmark-equivalent cov-
erage under this section unless, beginning on Janu-
ary 1, 2026, such coverage includes (and does not 
impose any deduction, cost sharing, or similar 
charge for) preventive opioid overdose reversal drugs 
described in section 1861(nnn).’’. 
(2) INCLUSION IN MEDICAL ASSISTANCE.— 
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(A) IN GENERAL.—Section 1905(a) of the 
Social Security Act (42 U.S.C. 1396d(a)) is 
amended— 
(i) in paragraph (31), by striking 
‘‘and’’ at the end; 
(ii) by redesignating paragraph (32) 
as paragraph (33); and 
(iii) by inserting after paragraph (31) 
the following new paragraph: 
‘‘(32) beginning January 1, 2026, preventive 
opioid overdose reversal drugs described in section 
1861(nnn); and’’. 
(3) 
APPLICATION
OF
REBATE
REQUIRE-
MENTS.—Section 1927 of the Social Security Act 
(42 U.S.C. 1396r–8) is amended— 
(A) in subsection (d)(7), by adding at the 
end the following new subparagraph: 
‘‘(F) Preventive opioid overdose reversal 
drugs described in section 1861(nnn) that are 
furnished as medical assistance in accordance 
with 
section 
1905(a)(32) 
and 
section 
1902(a)(10)(A).’’; and 
(B) in subsection (k)(4)— 
(i) by striking ‘‘If a State plan’’ and 
inserting: 
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‘‘(A) IN GENERAL.—If a State plan’’; and 
(ii) by adding at the end the following 
new subparagraph: 
‘‘(B) PREVENTIVE OPIOID OVERDOSE RE-
VERSAL DRUGS.—Beginning January 1, 2026, 
in applying paragraph (2)(A) to a preventive 
opioid overdose reversal drug described in sec-
tion 1861(nnn), such drug shall be deemed a 
prescribed 
drug 
for 
purposes 
of 
section 
1905(a)(12).’’. 
(4) PROHIBITION OF COST SHARING.— 
(A) IN GENERAL.—Section 1916 of the So-
cial Security Act (42 U.S.C. 1396o) is amend-
ed— 
(i) in subsection (a)(2)— 
(I) in subparagraph (I), by strik-
ing ‘‘or’’ at the end; 
(II) in subparagraph (J), by 
striking ‘‘; and’’ at the end and in-
serting ‘‘, or’’; and 
(III) by adding at the end the 
following new subparagraph: 
‘‘(K) beginning January 1, 2026, preven-
tive opioid overdose reversal drugs described in 
section 1861(nnn); and’’; and 
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(ii) in subsection (b)(2)— 
(I) in subparagraph (I), by strik-
ing ‘‘or’’ at the end; 
(II) in subparagraph (J), by 
striking ‘‘; and’’ at the end and in-
serting ‘‘, or’’; and 
(III) by adding at the end the 
following new subparagraph: 
‘‘(K) beginning January 1, 2026, preven-
tive opioid overdose reversal drugs described in 
section 1861(nnn); and’’. 
(B) APPLICATION TO ALTERNATIVE COST 
SHARING.—Section 1916A(b)(3)(B) of the So-
cial Security Act (42 U.S.C. 1396o–1(b)(3)(B)) 
is amended by adding at the end the following 
new clause: 
‘‘(xv) Beginning January 1, 2026, 
preventive opioid overdose reversal drugs 
described in section 1861(nnn).’’. 
(c) COVERAGE UNDER TRICARE.—Section 1074g 
of title 10, United States Code, is amended as follows: 
(1) In subsection (a)(6), by adding at the end 
the following new subparagraph: 
‘‘(F) Notwithstanding subparagraphs (A), (B), and 
(C), beginning on January 1, 2026, an eligible covered 
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beneficiary shall not be required to pay a cost-sharing 
amount for a preventive opioid overdose reversal drug.’’. 
(2) In subsection (i), by adding at the end the 
following new paragraph: 
‘‘(5) The term ‘preventive opioid overdose rever-
sal drug’ has the meaning given such term in section 
1861 of the Social Security Act (42 U.S.C. 
1395x).’’. 
(d) REGULATORY GUIDANCE.— 
(1) STATE
BOARDS.—Not later than 1 year 
after the date of the enactment of this Act, the 
Commissioner of Food and Drugs shall issue guid-
ance for State boards of pharmacy, nursing, and 
medicine with respect to— 
(A) enhancing safe and effective hospital- 
based dispensing and distribution of opioid 
overdose reversal drugs; and 
(B) eliminating barriers to such dispensing 
and distribution. 
(2) HOSPITAL.—Not later than 1 year after the 
date of the enactment of this Act, the Secretary of 
Health and Human Services shall issue guidance for 
hospitals with respect to billing for preventive opioid 
overdose 
reversal 
drugs 
described 
in 
section 
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1861(nnn) of the Social Security Act, as added by 
subsection (a)(2). 
(e) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require a provider of services 
or supplier to furnish a preventive opioid overdose reversal 
drug described in section 1861(nnn) of the Social Security 
Act, as added by subsection (a)(2), to an individual at risk 
of an opioid overdose. 
Æ 
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