Coverage of opioid treatments

(a) In general (1) PHSA Part D of title XXVII of the Public Health Service Act (42 U.S.C. 300gg–111 et seq.) is amended by adding at the end the following: 2799A–11. Coverage of opioid treatments A group health plan and a health insurance issuer offering group or individual health insurance coverage shall, at a minimum, with respect to a participant, beneficiary, or enrollee in the plan or coverage, provide coverage for and shall not impose any cost-sharing requirements for— (1) prescription drugs for the treatment of opioid use disorders or to reverse overdose; (2) behavioral health services for the treatment of opioid use disorders, including treatment of opioid use disorders in non-hospital residential facilities licensed to provide such treatment; or (3) community recovery support services that are provided in conjunction with, where appropriate, medication-assisted treatment for an opioid use disorder, such as peer counseling and transportation, to support the participant, beneficiary, or enrollee in maintaining a healthy lifestyle following opioid misuse treatment.. (2) ERISA (A) In general Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.) is amended by adding at the end the following: 726. Coverage of opioid treatments A group health plan and a health insurance issuer offering group health insurance coverage shall, at a minimum, with respect to a participant or beneficiary in the plan or coverage, provide coverage for and shall not impose any cost-sharing requirements for— (1) prescription drugs for the treatment of opioid use disorders or to reverse overdose; (2) behavioral health services for the treatment of opioid use disorders, including treatment of opioid use disorders in non-hospital residential facilities licensed to provide such treatment; or (3) community recovery support services that are provided in conjunction with, where appropriate, medication-assisted treatment for an opioid use disorder, such as peer counseling and transportation, to support the participant or beneficiary in maintaining a healthy lifestyle following opioid misuse treatment.. (B) Clerical amendment The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001 et seq.) is amended by inserting after the item relating to section 725 the following new item: Sec. 726. Coverage of opioid treatments.. (3) IRC (A) In general Chapter 100 of the Internal Revenue Code of 1986 is amended by adding at the end the following: 9826. Coverage of opioid treatments A group health plan shall, at a minimum, with respect to a participant or beneficiary in the plan, provide coverage for and shall not impose any cost-sharing requirements for— (1) prescription drugs for the treatment of opioid use disorders or to reverse overdose; (2) behavioral health services for the treatment of opioid use disorders, including treatment of opioid use disorders in non-hospital residential facilities licensed to provide such treatment; or (3) community recovery support services that are provided in conjunction with, where appropriate, medication-assisted treatment for an opioid use disorder, such as peer counseling and transportation, to support the participant or beneficiary in maintaining a healthy lifestyle following opioid misuse treatment.. (B) Clerical amendment The table of sections for subchapter B of chapter 100 of the Internal Revenue Code of 1986 is amended by adding at the end the following new item: Sec. 9826. Coverage of opioid treatments.. (b) Effective date The amendments made by subsection (a) shall apply with respect to plan years beginning on or after January 1, 2027.