MORE Savings Act
Bill: S.5008 | Sponsor: Sen. Casey, Robert P., Jr. (D-PA)
Policy area: Health

Summary:
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.
Private health insurers must also cover specified opioid treatments and MAT-associated recovery support services without cost-sharing.

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 recovery support services by health plans without 
                       cost-sharing requirements.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Maximizing Opioid Recovery Emergency 
Savings Act'' or the ``MORE Savings Act''.

SEC. 2. TESTING OF ELIMINATION OF MEDICARE COST-SHARING FOR EVIDENCE-
              BASED OPIOID TREATMENTS.

    Section 1115A(b)(2) of the Social Security Act (42 U.S.C. 
1315a(b)(2)) is amended--
            (1) in subparagraph (A), in the last sentence, by inserting 
        ``, and shall include the model described in subparagraph (D) 
        (which shall be implemented by not later than six months after 
        the date of the enactment of the Maximizing Opioid Recovery 
        Emergency Savings Act)'' before the period at the end; and
            (2) by adding at the end the following new subparagraph:
                    ``(D) Affordable access to evidence-based opioid 
                treatments.--
                            ``(i) In general.--The model described in 
                        this subparagraph is a model that seeks to 
                        provide affordable access to evidence-based 
                        opioid treatments and community-based recovery 
                        support services by eliminating coinsurance, 
                        copayments, and deductibles otherwise 
                        applicable under parts B and D of title XVIII 
                        (including as such parts are applied under part 
                        C of such title) for the following items and 
                        services that are otherwise covered under such 
                        parts:
                                    ``(I) Drugs and biologicals 
                                prescribed or furnished to treat opioid 
                                use disorders or reverse overdose.
                                    ``(II) Behavioral health and 
                                community support services furnished 
                                for the treatment of opioid use 
                                disorders, including treatment of 
                                addiction in non-hospital residential 
                                facilities licensed to furnish such 
                                treatment.
                                    ``(III) Recovery support services 
                                to maintain a healthy lifestyle 
                                following opioid misuse treatment, such 
                                as peer counseling and transportation.
                            ``(ii) Selection of sites.--The CMI shall 
                        select 15 States in which to conduct the model 
                        under this subparagraph. A State shall meet 
                        each of the following criteria in order to be 
                        selected under the preceding sentence:
                                    ``(I) The State has a high 
                                proportion of Medicare beneficiaries.
                                    ``(II) The State has a high rate of 
                                overdose deaths due to opioids.
                                    ``(III) The State has a significant 
                                percentage of rural areas.
                            ``(iii) Termination and modification 
                        provision not applicable for first five years 
                        of the model.--The provisions of paragraph 
                        (3)(B) shall apply to the model under this 
                        subparagraph beginning on the date that is five 
                        years after such model is implemented, but 
                        shall not apply to such model prior to such 
                        date.''.

SEC. 3. COVERAGE OF OPIOID TREATMENTS.

    Title XXVII of the Public Health Service Act is amended by 
inserting after section 2719A (42 U.S.C. 300gg-19a) the following:

``SEC. 2720. COVERAGE OF OPIOID TREATMENTS.

    ``A group health plan and a health insurance issuer offering group 
or individual health insurance coverage shall, at a minimum, 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 addiction in non-
        hospital residential facilities licensed to furnish 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 enrollee in maintaining a 
        healthy lifestyle following opioid misuse treatment.''.

SEC. 4. ENHANCED FEDERAL MATCH FOR MEDICATION-ASSISTED TREATMENT AND 
              RECOVERY SUPPORT SERVICES UNDER MEDICAID.

    (a) In General.--Section 1905(b) of the Social Security Act (42 
U.S.C. 1396d(b)) is amended by adding at the end the following: 
``Notwithstanding the first sentence of this subsection, the Federal 
medical assistance percentage shall be 90 percent with respect to 
amounts expended during the period described in subsection (a)(29) by a 
State that is one of the 50 States or the District of Columbia as 
medical assistance for medication-assisted treatment (as defined in 
subsection (ee)(1)).''.
    (b) State Option To Provide Recovery Support Services as Part of 
Medication-Assisted Treatment.--Section 1905(ee)(1) of the Social 
Security Act (42 U.S.C. 1396d(ee)(1)) is amended--
            (1) in subparagraph (A), by striking ``; and'' and 
        inserting a semicolon;
            (2) in subparagraph (B), by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following new subparagraph:
                    ``(C) at the option of a State, includes recovery 
                support services, such as peer counseling and 
                transportation, that are provided to an individual in 
                conjunction with the provision of such drugs and 
                biological products to support the individual in 
                maintaining a healthy lifestyle following opioid misuse 
                treatment.''.
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