S3522119th CongressWALLET

No Red Tape For Addiction Treatment Act

Sponsored By: Senator Hassan, Margaret Wood [D-NH]

Introduced

Summary

End prior authorization and dosage caps for at least one Medicaid-covered medication and biologic used to treat opioid use disorder. This bill would require State Medicaid plans and waivers to cover at least one formulation of every drug and biological listed at section 1905(a)(1)(A) without prior authorization or limits on dosage, and it explicitly includes long-acting and injectable formulations when available.

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  • People with opioid use disorder and families: Would make it easier to start and continue medication-assisted treatment by removing prior authorization and dosage limits for at least one formulation of each covered medication.
  • Clinicians and providers: Would cut paperwork and prescribing delays because at least one formulation would be available without prior approvals or dose restrictions.
  • State Medicaid programs: Would need to adjust formularies and coverage rules to meet the requirement, which applies to medical assistance provided on or after 1 year after enactment, with a limited implementation exception for states that require legislation.
  • Federal oversight and Congress: Directs the Medicaid and CHIP Payment and Access Commission to report to Congress within 1 year on utilization management controls for medication-assisted treatment, including dosing and age limits, counseling requirements, and administrative burdens on providers.

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Bill Overview

Analyzed Economic Effects

1 provisions identified: 1 benefits, 0 costs, 0 mixed.

Easier Medicaid access to addiction drugs

If enacted, the bill would require State Medicaid plans and waivers to cover at least one formulation of each medication used to treat opioid use disorder. That covered formulation would not be subject to prior authorization or limits on dosage. If available for a drug, the required coverage would include a long‑acting injectable version. The change would apply to medical care provided on or after one year after enactment. If a State needs a new State law to comply, HHS would not treat the State as failing to comply before the State has time to change its law. That extra time would extend until the first day of the first calendar quarter after the close of the State legislature's first regular session that begins after enactment. For States with two‑year legislative sessions, each year would count as a separate regular session. The bill would not prevent States from keeping a Medicaid drug list (formulary) consistent with current Medicaid rules (section 1927(d)(4)).

Sponsors & CoSponsors

Sponsor

Hassan, Margaret Wood [D-NH]

NH • D

Cosponsors

  • Sen. Justice, James C. [R-WV]

    WV • R

    Sponsored 12/17/2025

Roll Call Votes

No roll call votes available for this bill.

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