S665119th CongressWALLET

Fatal Overdose Reduction Act of 2025

Sponsored By: Senator Maria Cantwell

Introduced

Summary

Would establish Medicaid-funded Health Engagement Hubs to expand quick, walk-in access to treatment and harm-reduction services for opioid and other substance use disorders. This bill focuses on local hubs that combine medical care, peer support, and social services to reach people at high risk of overdose.

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  • People with substance use disorders and uninsured individuals: Would offer drop-in access, peer support, naloxone distribution, safer-use supplies, trauma-informed counseling, and rapid access to FDA‑approved medications for treatment within 4 hours, with sliding-scale fees for uninsured clients.
  • States and providers: Would allow up to 10 states to run a five-year demonstration using a State-chosen prospective payment system and receive a Federal Medical Assistance Percentage of at least 90% for Hub services under the demonstration.
  • Program design, oversight, and data: Would fund planning grants and administration, require monthly community advisory input, mandate state reporting beginning in year 3, and require a national implementation evaluation contracted by CMS.

*Would increase federal spending by at least $60.0 million for planning and administration and authorize enhanced Medicaid matching payments (90%) for Hub services.*

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 3 benefits, 0 costs, 0 mixed.

Hub rules, staffing, and locations

If enacted, certified Hubs would need to serve Medicaid-eligible people and uninsured people on a drop-in basis without appointments. Hubs must offer sliding-scale fees and cannot deny or limit services for inability to pay or place of residence. Hubs must show at least 12 months of prior OUD/SUD treatment experience and meet minimum staffing, including a licensed prescriber, a nurse, licensed behavioral health staff, peer support, and outreach/navigation staff with lived experience. States applying must describe their target populations, propose a PPS, list certified Hubs, verify each Hub meets certification, and assure at least 50 percent of Hubs are in areas with high overdose rates or mental-health professional shortages.

New Medicaid hub demonstration

If enacted, HHS would create a Health Engagement Hub demonstration to expand opioid and SUD care for Medicaid-eligible and uninsured people. The HHS Secretary would publish Hub certification and PPS guidance within 6 months. Up to 10 States could be chosen and HHS would only invite States that received planning grants to apply within 9 months after the first planning grant. Tribal entities could apply under similar rules. The bill would also provide $60 million in no-year funds for planning grants, technical help, data collection, and administration.

Walk-in addiction treatment and supplies

If enacted, certified Hubs would be paid under a State-selected prospective payment system for a wide set of services. Required services would include harm reduction and safer-use supplies, naloxone and overdose education, walk-in primary mental health and substance use services, peer support, targeted case management, wound care, vaccinations and testing, sexual and reproductive health supplies, secure medication storage, and outreach/navigation. Prescribed drugs and covered outpatient drugs would still be paid separately under a State plan or waiver and must follow Medicaid and rebate rules.

Sponsors & CoSponsors

Sponsor

Maria Cantwell

WA • D

Cosponsors

  • Bill Cassidy

    LA • R

    Sponsored 2/20/2025

Roll Call Votes

No roll call votes available for this bill.

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