S. 2072 — MORE Savings Act

This section requires the Center for Medicare and Medicaid Innovation (CMI) to test a new payment and service delivery model—providing affordable access to evidence-based opioid treatments by eliminating Medicare coinsurance, copayments, and deductibles under Parts B and D (as applied under Part C)—which must be implemented within six months of enactment. The model covers (1) drugs and biologicals to treat opioid use disorders or reverse overdose; (2) behavioral health and community support services for opioid use disorders, including treatment in licensed non-hospital residential facilities; and (3) recovery support services such as peer counseling and transportation. The CMI must select 15 states with high proportions of Medicare beneficiaries, high opioid overdose death rates, and significant rural areas to conduct the model, which is exempt from termination or significant modification for its first five years (under current law paragraph (3)(B)). (As background, the CMI tests models to reduce Medicare and Medicaid expenditures while preserving or enhancing care quality.)

This section requires group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage, at a minimum and with no cost-sharing requirements, for (1) prescription drugs to treat opioid use disorders or reverse overdoses, (2) behavioral health services to treat opioid use disorders including in licensed non-hospital residential facilities, and (3) community recovery support services (e.g., peer counseling and transportation) provided in conjunction with medication-assisted treatment to support maintaining a healthy lifestyle after opioid misuse treatment. The requirement is codified through parallel amendments adding new sections to Part D of title XXVII of the Public Health Service Act (42 U.S.C. 300gg–111 et seq.), subpart B of part 7 of subtitle B of title I of ERISA (29 U.S.C. 1185 et seq.), and chapter 100 of the Internal Revenue Code of 1986, and applies to plan years beginning on or after January 1, 2027.

This section establishes a 90% federal medical assistance percentage (FMAP) for amounts expended by the 50 states or the District of Columbia as Medicaid medical assistance for medication-assisted treatment (MAT)—as defined in SSA section 1905(ee)(1)—during the portion of the period specified in SSA section 1905(a)(29) that begins on the date of enactment. The section further amends the definition of MAT to allow states, at their option, to include recovery support services—such as peer counseling and transportation—provided in conjunction with FDA-approved drugs and biological products for opioid use disorder to support maintaining a healthy lifestyle following treatment.