S. 665 — Fatal Overdose Reduction Act of 2025

This section establishes a demonstration program under Medicaid (Title XIX of the Social Security Act) to increase access to treatment for opioid use disorder and other substance use disorders through Health Engagement Hubs certified by states. (As background, Medicaid provides federal matching funds to states for health coverage to low-income individuals, including those with substance use disorders; the program supports drop-in hubs offering person-centered services—directly or via partnerships—to Medicaid-eligible and uninsured individuals in high-need communities disproportionately impacted by overdoses, such as rural, tribal, homeless, and criminal justice-involved populations.) It directs the Secretary, not later than six months after enactment, to publish (1) certification criteria for Health Engagement Hubs (which may be further defined as needed); (2) guidance for participating states to establish a prospective payment system applicable only to required hub services furnished to Medicaid enrollees in compliance with Medicaid rules; (3) clarifications that such payments exclude prescribed or covered outpatient drugs (except for prescription or administration services if needed) but permit separate reimbursement under the state plan; and (4) participation requirements for Indian tribes, tribal organizations or consortia, and Urban Indian organizations similar to those for states. Hub certification requires drop-in access to social and medical services; evidence-based engagement models (e.g., motivational interviewing, shared decision-making); prioritization of high-need locations; and provision of overdose education with drugs or devices approved for emergency opioid reversal (e.g., naloxone).

This section requires the Comptroller General of the United States to provide to the Senate Committee on Finance and the House Committee on Energy and Commerce, not later than 18 months after receipt of annual state reports and the national implementation evaluation findings under section 1903(cc)(6)(C) of the Social Security Act, a report assessing the Secretary's evaluation of the Health Engagement Hub Demonstration Program (a Medicaid demonstration program established by this Act).