HANDS Act
The HANDS Act (Hospitals As Naloxone Distribution Sites Act) would require no-cost coverage for preventive opioid overdose reversal drugs (primarily naloxone) across Medicare, Medicaid, TRICARE, and related programs, starting January 1, 2026. The bill defines a preventive opioid overdose reversal drug as an intranasal or intramuscular naloxone product provided by a clinician to a hospital inpatient, a patient in the emergency department, or a patient leaving an emergency department, ambulatory surgical center, or certain hospital settings, only if the clinician determines the patient is at risk of overdose and the drug is given at discharge with administration instructions. It also broadens coverage and eliminates cost sharing for these drugs in multiple programs, and requires related regulatory guidance. In practice, the bill aims to remove patient cost-sharing for naloxone distributed in hospital-based settings at or near the point of discharge, expand mandatory coverage under Medicaid, and apply similar protections to TRICARE. It also directs regulatory action to improve hospital dispensing and billing for these drugs and clarifies that providers are not required to furnish the drug to every patient at risk. The overall goal is to increase access to overdose reversal medication at critical moments to reduce opioid overdose deaths.
Key Points
- 1No-cost coverage in Medicare Part B for preventive opioid overdose reversal drugs furnished on or after January 1, 2026, including the elimination of cost sharing for these drugs in Medicare Advantage plans.
- 2Definition of “preventive opioid overdose reversal drug”: an intranasal or intramuscular reversal drug provided by a clinician to an inpatient or during discharge from a hospital-like setting (hospital, critical access hospital, rural emergency hospital, ED, or ambulatory surgical center) to a patient deemed at risk, with instructions for use.
- 3Medicare cost-sharing reform: for these drugs, payments would be 100% of the lesser of the actual charge or the standard payment amount under the applicable Medicare drug/payment schedules.
- 4Medicaid expansion: mandatory coverage beginning January 1, 2026, requiring no deductions or cost-sharing for preventive opioid overdose reversal drugs, and inclusion in medical assistance as a covered item.
- 5TRICARE: no cost-sharing for preventive opioid overdose reversal drugs beginning January 1, 2026, for eligible beneficiaries.
- 6State and hospital guidance: within one year of enactment, federal guidance to state boards of pharmacy/nursing/medicine to ease safe hospital-based dispensing and remove barriers; hospitals to receive guidance on billing for these drugs.
- 7Rule of construction: the bill does not mandate that every patient at risk must be given a preventive reversal drug; it targets no-cost access where a clinician determines need at discharge or exit from care.