{"id":341,"date":"2017-12-14T00:00:00","date_gmt":"2017-12-14T00:00:00","guid":{"rendered":"https:\/\/eccovia.com\/index.php\/2017\/12\/14\/sud-waivers-tackling-opioid-crisis-go-hand-hand\/"},"modified":"2024-03-13T18:18:29","modified_gmt":"2024-03-13T18:18:29","slug":"sud-waivers-tackling-opioid-crisis-go-hand-hand","status":"publish","type":"post","link":"https:\/\/eccovia.com\/blog\/sud-waivers-tackling-opioid-crisis-go-hand-hand\/","title":{"rendered":"SUD Waivers And Tackling The Opioid Crisis Go Hand In Hand"},"content":{"rendered":"<div id=\"bsf_rt_marker\"><\/div><p>To\u00a0allow greater flexibility and encourage greater innovation in\u00a0tackling\u00a0Substance\u00a0Use\u00a0Disorder (SUD)\u00a0and Opioid Use Disorder (OUD), special waivers are available for each state to relax Medicaid requirements and\u00a0implement uniquely crafted programs. CMS oversees the application of these waivers, and are the ultimate arbiters of their approval.\u00a0A type of\u00a0Section 1115 waiver,\u00a0SUD and OUD waivers\u00a0empower states to design demonstration projects that result in greater access to treatment for opioid use and other substance abuse disorders.\u00a0In recent weeks, Utah and New Jersey had\u00a0SUD\u00a0waivers approved.<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<p>A driving purpose of these\u00a0waivers is to provide better treatment for Medicaid patients suffering from substance abuse disorder. West Virginia, which had the nation\u2019s highest drug overdose death rate in 2015, has implemented a section<a href=\"https:\/\/eccoviasolutions.com\/community-care-coordination\/1115-whole-person-care-waiver-programs\/\"> 1115 waiver<\/a> and their demonstration project, as approved by CMS, highlights many of the desired outcomes for other states seeking waivers. Building on the Medicaid expansion of 2014, their project seeks to further their efforts by:<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\">Broadening the scope of SUD services that the state\u2019s Medicaid program pays for so the state can pay for multiple services that may be needed in order to\u00a0deliver whole person care<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\">Improving the quality of care by aligning their continuum of care guidelines with those recommended by the American Society of Addiction Medicine Criteria<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\">Working with CMS to create a system for monitoring quality and health outcomes<\/li>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\">Thoroughly evaluating their demonstration\u00a0by having an independent third party evaluate how well it meets its objectives<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<li data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"1\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\">Sharing lessons learned\u00a0with the national SUD community to help improve their system of care<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<p>The efforts in West Virginia are a prime example of how to implement the general guidelines created by CMS that must be incorporated into any state\u2019s demonstration project. Earlier this year, the CMS administration issued a letter to governors clarifying the programs primary objectives. Their approach has become more flexible and streamlined as part of their efforts, enabling states to respond to the growing opioid crisis with greater speed and efficiency.\u00a0<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<p>As the opioid and substance\u00a0use\u00a0problems have increased in occurrence, CMS has actively tried to improve access to OUD and other SUD treatment services for Medicaid beneficiaries. Medicaid beneficiaries have higher rates of Opioid Use Disorder (OUD) than the general population, accounting for 25% of adult cases in 2015. Sadly, only 32% of those beneficiaries received treatment.\u00a0Adding to the difficulty or providing treatment to Medicaid beneficiaries is the fact that 40% of counties in the U.S. do not have an addiction treatment facility that provides outpatient care and accepts Medicaid. CMS has keenly followed the research growing the OUD and SUD epidemics, and are actively working to improve Medicaid beneficiaries\u2019 access to high-quality, evidence-based treatment services for addiction to opioids or other substances.\u00a0They are hoping states use these waivers to help accomplish these goals.<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<p>Recognizing that states will bring a degree of creativity and unique ideas to their demonstration proposals, CMS has\u00a0helped direct these efforts to provide the goals that any project must accomplish, and the milestones they will use in evaluating the success of the project. For their primary goals, CMS has determined all projects must accomplish:\u00a0<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"%1.\" data-font=\"Calibri, sans-serif\" data-listid=\"2\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\">Increased rates of identification, initiation, and engagement in treatment<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"%1.\" data-font=\"Calibri, sans-serif\" data-listid=\"2\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\">Increased adherence to and retention in treatment<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"%1.\" data-font=\"Calibri, sans-serif\" data-listid=\"2\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\">Reductions in overdose deaths, particularly those due to opioids<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"%1.\" data-font=\"Calibri, sans-serif\" data-listid=\"2\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\">Reduced utilization of emergency departments and inpatient hospital settings for treatment where the utilization is preventable or medically inappropriate through improved access to other continuum of care services<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"%1.\" data-font=\"Calibri, sans-serif\" data-listid=\"2\" aria-setsize=\"-1\" data-aria-posinset=\"5\" data-aria-level=\"1\">Fewer readmissions to the same or higher level of care where the readmission is preventable or medically inappropriate<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"%1.\" data-font=\"Calibri, sans-serif\" data-listid=\"2\" aria-setsize=\"-1\" data-aria-posinset=\"6\" data-aria-level=\"1\">Improved access to care for physical health conditions among beneficiaries<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<p>States wishing to participate in these efforts are encouraged to develop proposals incorporating these goals.\u00a0Recognizing that the implementation of these demonstration projects may not always go according to plan, CMS is helping states\u00a0by providing implementation and monitoring protocols designed to make useful data from other states efforts available for all to learn from, and allow states the ability to make project adjustments as needed. Milestones established by CMS that must be accomplished by\u00a0SUD and OUD\u00a0demonstration projects include:<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:45,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"%1.\" data-font=\"Calibri, sans-serif\" data-listid=\"3\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\">Access to critical levels of care for OUD and other SUDs<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"%1.\" data-font=\"Calibri, sans-serif\" data-listid=\"3\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\">Widespread use of evidence-based, SUD-specific patient placement criteria<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"%1.\" data-font=\"Calibri, sans-serif\" data-listid=\"3\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\">Use of nationally recognized, evidence-based SUD program standards to set residential treatment provider qualifications<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"%1.\" data-font=\"Calibri, sans-serif\" data-listid=\"3\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\">Sufficient provider capacity at each level of care<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"%1.\" data-font=\"Calibri, sans-serif\" data-listid=\"3\" aria-setsize=\"-1\" data-aria-posinset=\"5\" data-aria-level=\"1\">Implementation of comprehensive treatment and prevention strategies to address opioid abuse and OUD<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"%1.\" data-font=\"Calibri, sans-serif\" data-listid=\"3\" aria-setsize=\"-1\" data-aria-posinset=\"6\" data-aria-level=\"1\">Improved care coordination and transitions between levels of care<span data-ccp-props=\"{&quot;134233279&quot;:true,&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/li>\n<\/ul>\n<p>As states such as West Virginia and Maryland have proceeded in their demonstration projects, they have provided valuable data that CMS has incorporated into their updated goals and milestones. Washington state has even seen significant reductions in medical costs among Medicaid beneficiaries who accessed addiction treatment compared to those who did not.\u00a0CMS is hoping this success can\u00a0lead the way for\u00a0other states as we work together to address the growing SUD and OUD crisis.<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559685&quot;:45,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<h3>Blog Resources<\/h3>\n<p><a href=\"https:\/\/www.cbpp.org\/blog\/west-virginias-new-medicaid-waiver-promotes-medicaid-objectives\">https:\/\/www.cbpp.org\/blog\/west-virginias-new-medicaid-waiver-promotes-medicaid-objectives<\/a><\/p>\n<p><a href=\"http:\/\/news.aha.org\/article\/171101-new-cms-waiver-policy-aims-to-expand-medicaid-treatments-for-suds\">http:\/\/news.aha.org\/article\/171101-new-cms-waiver-policy-aims-to-expand-medicaid-treatments-for-suds<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>To\u00a0allow greater flexibility and encourage greater innovation in\u00a0tackling\u00a0Substance\u00a0Use\u00a0Disorder (SUD)\u00a0and Opioid Use Disorder (OUD), special waivers are available for each state to relax Medicaid requirements and\u00a0implement uniquely crafted programs. CMS oversees [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":33094,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"content-type":"","inline_featured_image":false,"_EventAllDay":false,"_EventTimezone":"","_EventStartDate":"","_EventEndDate":"","_EventStartDateUTC":"","_EventEndDateUTC":"","_EventShowMap":false,"_EventShowMapLink":false,"_EventURL":"","_EventCost":"","_EventCostDescription":"","_EventCurrencySymbol":"","_EventCurrencyCode":"","_EventCurrencyPosition":"","_EventDateTimeSeparator":"","_EventTimeRangeSeparator":"","_EventOrganizerID":[],"_EventVenueID":[],"_OrganizerEmail":"","_OrganizerPhone":"","_OrganizerWebsite":"","_VenueAddress":"","_VenueCity":"","_VenueCountry":"","_VenueProvince":"","_VenueState":"","_VenueZip":"","_VenuePhone":"","_VenueURL":"","_VenueStateProvince":"","_VenueLat":"","_VenueLng":"","_VenueShowMap":false,"_VenueShowMapLink":false,"footnotes":""},"categories":[62],"tags":[5,33],"acf":[],"yoast_head":"<!-- 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