Substance use disorder (SUD) is a significant public health issue that disproportionately affects the Medicaid program. Historically, Medicaid has provided limited coverage for residential SUD treatment due to federal rules prohibiting federal matching funds for services provided in institutions for mental disease (IMDs). That policy has made it difficult for states to meet the need for residential treatment amid rising rates of opioid use disorder (OUD). In response, the Centers for Medicare & Medicaid Services (CMS) has encouraged states to pursue Section 1115 demonstrations that allow them waive that restriction and address other gaps in the SUD treatment continuum.
To complement MACPAC’s ongoing work on improving access to OUD treatment, staff assembled an expert panel to share their insights and experiences with the Commission. Medicaid directors from New Hampshire and West Virginia discussed their demonstration goals and implementation experiences, as well as areas where they have seen progress. A former CMS official and state technical assistance provider discussed CMS’s expectations for the demonstrations, including required state monitoring and evaluation activities, and areas where more information is needed to understand whether demonstrations are meeting their stated goals.
Panelists included:
- Cynthia Beane, Bureau of Medical Services, West Virginia Department of Health and Human Services
- Henry Lipman, Director, Division of Medicaid Services, New Hampshire Department of Health and Human Services
- John O’Brien, National Advisor for Manatt Health
