Fatal Overdose Reduction Act of 2025
Key claim: The Fatal Overdose Reduction Act of 2025 would create a five-year Medicaid demonstration program offering states at least 90% federal matching funds for comprehensive opioid and substance use disorder services delivered through certified Health Engagement Hubs.
Abstract
(S665 · 119th Congress) Fatal Overdose Reduction Act of 2025 This bill establishes a five-year Medicaid demonstration program to support the provision of comprehensive and accessible services to treat opioid use and substance use disorders. Specifically, the bill establishes a demonstration program through which states may receive a Federal Medical Assistance Percentage (i.e., federal matching rate) of at least 90% for services provided by organizations that serve as Health Engagement Hubs. States must certify that these organizations provide a certain level of services, including physical and behavioral health services that are easily and quickly accessible, peer support services, and targeted case management. Organizations must also meet specified minimum staffing requirements, have a community advisory board, and be equipped to provide certain social services (e.g., employment counseling). The Centers for Medicare & Medicaid Services (CMS) may select up to 10 states to participate in the program. The bill provides funds for state planning grants and administration of the program. The CMS must contract with an entity to evaluate the program, and the Government Accountability Office must report on this evaluation. Latest action (2025-02-20): Read twice and referred to the Committee on Finance.
Why this matters
If enacted, the Fatal Overdose Reduction Act would give states a strong fiscal incentive (≥90% federal match) to stand up integrated ‘Health Engagement Hubs’ delivering MOUD, harm reduction, and behavioral health services to Medicaid enrollees, potentially reshaping how SUD care is organized and paid for. For patients, this could mean lower-barrier access to naloxone and treatment through Medicaid; for states and providers, it introduces a new certification pathway and demonstration structure to navigate. The bill is currently at the introduced stage with no CMS implementation activity.