Massachusetts H4958 mandates coverage for opioid antagonists and agonists in treating opioid use disorder without cost-sharing.
Massachusetts H4958 requires health insurers, health maintenance organizations, and other health care providers to cover opioid antagonists and agonists, including partial agonists, used in treating opioid use disorder. The bill mandates that these treatments be deemed medically necessary and exempt from prior authorization, deductibles, coinsurance, copayments, and out-of-pocket limits. It also ensures that health care facilities are reimbursed for these treatments, preventing them from balance billing patients.
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