CMS announced the approval of both the Oklahoma and Maine section 1115 demonstrations to expand treatment for substance abuse disorder (SUD). CMS approved Oklahoma’s new demonstration, titled “Institutions for Mental Diseases Waiver for Serious Mental Illness/Substance Use Disorder,” and Maine’s new demonstration, entitled “Maine Substance Use Disorder (SUD) Care Initiative.”
The approval of these demonstrations opens the door to critical treatment options including continuity of care in the community following episodes of acute care in hospitals and residential treatment facilities that qualify as Institutions of Mental Diseases (IMDs) as it allows the Oklahoma and Maine Medicaid programs to overcome longstanding payment exclusions. Oklahoma now has the authority to receive federal Medicaid payment for medically necessary residential SMI, SED and/or SUD treatment in IMDs, and Maine has the authority to receive federal Medicaid payment for SUD treatment in IMDs.
In addition, the Oklahoma demonstration provides facility-based stabilization of beneficiaries who are in a crisis due to mental health diseases and SUD. The demonstration will allow inpatient treatment services for short-term residents within settings that qualify as IMDs and includes services made available through call centers, mobile crisis units and intensive outpatient services.
CMS is already seeing results from other approved SUD demonstrations that improve access to opioid treatment in other states: In Virginia, the number of Medicaid beneficiaries with SUD receiving SUD services increased 104%, from 13,389 to 27,319.
For more information on each demonstration, visit the links below: