Fatal Overdose Reduction Act of 2025

This bill would create a five-year Medicaid pilot to open “Health Engagement Hubs” — drop‑in centers where people can quickly get help for opioid and other substance use problems. Up to 10 states could take part, with priority for places with high overdose deaths and a mix of regions. The federal government would cover at least 90% of the cost of covered hub services for Medicaid patients. It also provides planning grants and $60 million to launch and run the program.

Hubs must offer easy, walk‑in care, including evenings and weekends. Services include harm‑reduction supplies and education, overdose reversal medicine like naloxone, fast access to medicines that treat opioid use disorder, basic medical and mental health care, wound care, vaccines and testing, sexual and reproductive health care, medication management, case management, peer support, and help navigating systems. They can also help with IDs, job counseling, recovery supports, family reunification, and legal needs. Hubs must serve people without insurance on a sliding‑fee basis and cannot turn someone away because of ability to pay or where they live. Each hub must have key staff (a licensed prescriber, a nurse, a behavioral health clinician, and peer staff) and a community advisory board of people with lived experience. Drug costs are paid separately and are not bundled into the hub payment.

• Who is affected: People on Medicaid and people without insurance; communities hit hard by overdose; tribal and Urban Indian organizations can apply to participate.
• What changes: States can certify and fund hubs; at least half of a state’s hubs must be in high‑overdose or mental‑health‑shortage areas; drug costs are paid separately; states must report results, and an outside evaluation and a GAO review will check how well the program works.
• When: The pilot runs for five years in up to 10 states; federal guidance will set standards before states start.