New Mass. law mandates insurance coverage of Narcan, opioid reversal drugs

With Gov. Maura Healey’s signature last week, the state mandated that insurance providers cover overdose reversal drugs such as naloxone, commonly known by the brand name Narcan.

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Passed by the Legislature earlier this month and signed into law on Dec. 23, the “Act Relative to Treatments and Coverage for Substance Use Disorder and Recovery Coach Licensure” requires all health plans in Massachusetts to cover the overdose reversal drugs without cost-sharing or prior authorization.

Naloxone is the most well-known of these, but other options are also emerging on the market, such as nalmefene.

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In March 2023, the U.S. Food and Drug Administration approved the first over-the-counter naloxone nasal spray. Today, via a Department of Public Health standing order, naloxone is available at many pharmacies and stores across the state, with or without a prescription.

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Massachusetts and the nation experienced an overall drop in overdose deaths last year for the first time in five years, and many point to expanded access to opioid reversal drugs, among other public health measures, as a likely reason why.

In June, the Department of Public Health reported it had distributed more than 196,500 naloxone kits (two doses per kit) since 2023, resulting in at least 10,206 overdose reversals.

The bill requires pharmacies in areas of high incidences of overdoses to maintain a consistent supply, and they have to report whenever there are supply chain problems preventing that.

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“I’m proud to sign this bill that will expand access to lifesaving overdose reversal medications and coaching throughout the recovery process,” Healey said in a statement. “I’m grateful to our partners in the Legislature for their leadership in making sure Massachusetts continues to be a national leader in the fight against the opioid crisis.”

Dr. Sarah Wakeman, senior medical director for substance use disorders at Mass General Brigham, said she sees firsthand the “transformative impact” overdose reversal medications can have on patients and their families.

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The legislation also requires hospitals and treatment facilities to educate patients on opioid reversal drugs, or dispense at least two doses to patients with a history of overdose, opioid use or opioid use disorder upon discharge.

In addition, it prohibits life insurance companies from limiting or refusing coverage to a person solely because they obtained an opioid reversal drug for themselves or others.

The Republican reporter Dave Canton contributed to this story.