H.R. 5120 — HANDS Act

This section requires Medicare Part B and Medicaid to cover, with no cost-sharing, preventive opioid overdose reversal drugs (i.e., intranasal or intramuscular opioid overdose reversal drugs such as naloxone furnished at discharge with instructions to at-risk patients from hospitals, critical access hospitals, rural emergency hospitals, or their emergency departments or ambulatory surgical centers) furnished on or after January 1, 2026. **(a) Medicare**—Adds such drugs as a covered physician service under SSA §1861(s)(2)(KK); requires payment at 100% of the lesser of actual charges or the physician fee schedule amount with no deductible; and extends the no-cost-sharing requirement to Medicare Advantage plans. **(b) Medicaid**—Makes coverage mandatory under state plan requirements and benchmark/alternative benefit plans; includes such drugs as a mandatory benefit under SSA §1905(a)(32); applies manufacturer rebate requirements; and prohibits all cost-sharing, including under alternative cost-sharing plans.