No Red Tape for Addiction Treatment Act: A Bipartisan Step to Speed Lifesaving Care

When someone asks for help with opioid addiction, time matters. Delays can quickly become life-threatening and can reduce the chance of long-term recovery. Withdrawal can be painful, and without prompt treatment, many people return to use just to stop the symptoms.

Yet Medicaid prior authorization rules can force patients and clinicians to wait for approval before a pharmacy can dispense medication. Those delays can turn a treatment moment into a missed moment and can extend a period of high overdose risk.

That is why Senators Maggie Hassan (D-NH) and Jim Justice (R-WV) introduced the bipartisan No Red Tape for Addiction Treatment Act. Senator Hassan framed the problem and the solution in plain terms. "When someone takes the courageous step to seek treatment, bureaucratic red tape should not stand in their way." Senator Justice echoed the same urgency. "When someone asks for help, the answer shouldn’t be a stack of paperwork." 

What the bill does

The No Red Tape for Addiction Treatment Act removes a bureaucratic barrier in Medicaid. The bill requires state Medicaid programs to cover at least one formulation of each FDA approved medication for opioid use disorder without prior authorization, including long-acting injectable options when available. 

In Medicaid, utilization controls are rules that limit, delay or require approval before someone can receive care. They’re meant to control costs—but they can be dangerous, especially for people with serious or time-sensitive conditions like opioid use disorder. The No Red Tape for Addiction Treatment Act also directs the Medicaid and CHIP Payment Advisory Commission to issue a report to Congress on how states use tools such as dosing limits, age restrictions, counseling requirements and psychological screening for medication assisted treatment and how these controls burden clinicians. The report must also identify other Medicaid policies that hinder access to treatment.

Why this policy change matters

Medication for opioid use disorder works. Federal regulators recognize buprenorphine, methadone and naltrexone as the FDA-approved medications used to treat opioid use disorder. Strong evidence links treatment retention to lower mortality. A major systematic review and meta-analysis found that people face much lower risk of death while taking methadone or buprenorphine and risk rises sharply right after treatment stops. 

Medicaid is the largest payer of OUD treatment in the U.S.  The HHS Office of Inspector General estimates Medicaid covers about 40 percent of nonelderly, over 65 years old, adults with opioid use disorder, meaning Medicaid policies shape access to treatment for millions of people nationwide. A rule that adds days of delay can scale across millions of people.

The Medicaid And CHIP Payment and Access Commission (MACPAC), a nonpartisan legislative agency that makes recommendations to Congress on Medicaid and CHIP policies, has documented that prior authorization for medications for opioid use disorder and daily dosage caps for oral buprenorphine rank among commonly cited barriers to timely and effective treatment in Medicaid. MACPAC also describes wide variation in access and treatment delivery across states, which creates uneven care depending on geography. 

What prior authorization looks like in real life

In practice, after assessing a patient, a clinician writes a prescription. However, before a patient can pick up their prescription, an insurer requires extra paperwork or a separate approval before it pays for medication. Sometimes a patient leaves a visit ready to start treatment, only to discover at the pharmacy counter that coverage has not cleared.

In overdose prevention, that gap carries risk. As Libby Jones, Associate Vice President for the Global Health Advocacy Incubator’s (GHAI) Overdose Prevention Initiative said, "In the aftermath of a non-fatal overdose, every minute counts. Paperwork can be deadly." 

This bill aims to make Medicaid work in real time, with faster access to proven medication and fewer interruptions in care. 

A bipartisan bill for a national problem

The Hassan-Justice partnership matters because it signals agreement on a simple principle that paperwork should not decide who gets evidence-based care. The overdose crisis touches every region. Rural counties face long drives to the nearest clinic. Cities face high volume and strained emergency departments. Families in every state face the same core threat, a toxic drug supply and a treatment system that still blocks proven care.

A federal fix that speeds access in Medicaid reaches every region, rural and urban, red states and blue states. It supports families across the nation, because the barrier looks the same at the pharmacy counter no matter the location.

Building on recent progress

Congress removed a major federal barrier to care by eliminating the special waiver once required to prescribe buprenorphine for opioid use disorder. The No Red Tape for Addiction Treatment Act builds on that progress by addressing a different chokepoint. A prescription only helps if a patient can fill it without delay.

What success looks like

Passage should lead to fewer stalled starts, fewer interruptions and fewer people leaving a visit without medication. It should also reduce paperwork load that pushes clinicians away from providing treatment.

GHAI’s position is simple. Lives depend on speed and access. Congress should pass the No Red Tape for Addiction Treatment Act and ensure no one waits for care that could save their life.