This bill amends various chapters of the General Laws to ensure comprehensive coverage for opioid use disorder treatment. It mandates that insurance policies, including those under the group insurance commission, Medicaid managed care organizations, and various health plans, provide coverage for prescribed or dispensed opioid antagonists and opioid agonists, including partial agonists. The coverage is deemed medically necessary and does not require prior authorization or a prescription from a healthcare practitioner. Additionally, these medications will not be subject to deductibles, coinsurance, copayments, or out-of-pocket limits, although cost-sharing may be required for plans governed by the Internal Revenue Code to maintain tax-exempt status.

The bill also stipulates that coverage for these medications must be provided as both a medical benefit when dispensed or administered by healthcare facilities and as a pharmacy benefit when dispensed by pharmacists. The reimbursement rates for medical benefits cannot exceed the average in-network pharmacy benefit rate, and healthcare facilities are prohibited from balance billing patients. The bill aims to enhance access to essential treatments for individuals suffering from opioid use disorder, thereby addressing a critical public health issue.