[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 3522 Introduced in Senate (IS)]
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119th CONGRESS
1st Session
S. 3522
To amend title XIX of the Social Security Act to require that State
Medicaid programs provide at least one formulation of each type of
medication for the treatment of opioid use disorder without prior
authorization or limitations on dosage, and for other purposes.
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IN THE SENATE OF THE UNITED STATES
December 17, 2025
Ms. Hassan (for herself and Mr. Justice) introduced the following bill;
which was read twice and referred to the Committee on Finance
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A BILL
To amend title XIX of the Social Security Act to require that State
Medicaid programs provide at least one formulation of each type of
medication for the treatment of opioid use disorder without prior
authorization or limitations on dosage, and for other purposes.
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 ``No Red Tape For Addiction Treatment
Act''.
SEC. 2. PROVISION OF MEDICATION-ASSISTED TREATMENT FOR OPIOID USE
DISORDER WITHOUT PRIOR AUTHORIZATION OR LIMITATIONS ON
DOSAGE UNDER MEDICAID.
(a) In General.--Section 1905 of the Social Security Act (42 U.S.C.
1396d) is amended--
(1) in subsection (a)(29), by striking ``(2) and (3)'' and
inserting ``(2), (3), and (4)''; and
(2) in subsection (ee), by adding at the end the following
new paragraph:
``(4) Provision of medication-assisted treatment without
prior authorization.--
``(A) In general.--A State plan (or a waiver of
such plan) shall provide coverage of at least 1
formulation of each drug and biological product
described in paragraph (1)(A) (which shall include, if
available with respect to such a drug or biological
product, a formulation that is long-lasting and
injectable) that is not subject to prior authorization
or limitations on dosage as a condition of coverage or
payment for such drug or biological product.
``(B) Rule of construction.--The requirement under
subparagraph (A) to provide coverage of at least 1
formulation of each drug and biological product
described in paragraph (1)(A) shall not be construed as
modifying or limiting the ability of a State to
establish a formulary that is consistent with the
requirements of section 1927(d)(4).''.
(b) Conforming Amendment.--Section 1927(d)(1)(A) of the Social
Security Act (42 U.S.C. 1396r-8(d)(1)(A)) is amended by striking ``A
State'' and inserting ``Except as provided in section 1905(ee)(4), a
State''.
(c) Effective Date.--
(1) In general.--Subject to paragraph (2), the amendments
made by this subsection shall apply with respect to medical
assistance provided on or after the date that is 1 year after
the date of enactment of this Act.
(2) Exception for state legislation.--In the case of a
State plan under title XIX of the Social Security Act (42
U.S.C. 1396 et seq.) that the Secretary of Health and Human
Services determines requires State legislation in order for
such plan to meet any requirement imposed by the amendments
made by this section, such plan shall not be regarded as
failing to comply with the requirements of such title solely on
the basis of its failure to meet such an additional requirement
before the first day of the first calendar quarter beginning
after the close of the first regular session of the State
legislature that begins after the date of the enactment of this
Act. For purposes of the previous sentence, in the case of a
State that has a 2-year legislative session, each year of the
session shall be considered to be a separate regular session of
the State legislature.
SEC. 3. MACPAC REPORT ON UTILIZATION OF MANAGEMENT CONTROLS ON THE
TREATMENT OF OPIOID USE DISORDER UNDER MEDICAID.
Not later than 1 year after the date of enactment of this section,
the Medicaid and CHIP Payment and Access Commission shall submit to
Congress a report on issues related to utilization management controls
for medication-assisted treatment of opioid use disorder under the
Medicaid program. Such report shall include--
(1) an analysis and description of the use of utilization
management controls for medication-assisted treatment furnished
through the Medicaid program across all States (as defined in
section 1101(a)(1) of the Social Security Act (42 U.S.C.
1301(a)(1)) for purposes of title XIX of such Act), including
dosing restrictions, age limits, counseling requirements, and
psychological screening requirements;
(2) an assessment of the extent to which such utilization
management controls impose an administrative burden on
clinicians and other providers; and
(3) an assessment of other Medicaid policies, at both the
Federal and State level, that impede patient access to
medication-assisted treatment and complicate clinician or
provider prescribing practices.
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