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CMS policy paves way for expanded access to opioid treatment

The agency is also announcing the immediate approval of both New Jersey and Utah's demonstration waivers under the new policy.

Jeff Lagasse, Associate Editor

The the Centers for Medicare and Medicaid Services has announced a new policy to allow states to design demonstration projects that increase access to treatment for opioid use disorder and other substance use disorders.

CMS's new demonstration policy was prompted by President Donald Trump's directive and provides states with greater flexibility to design programs that improve access to appropriate, quality treatment. The agency is also announcing the immediate approval of both New Jersey and Utah's demonstration waivers under the new policy.

[Also: Trump declares opioid epidemic a public health emergency]

Through this updated policy, states will be able to pay for a fuller continuum of care to treat substance use disorders, including treatment in residential treatment facilities for which Medicaid is unable to pay without a waiver.

"Previous policies ignored the growing urgency of the national opioid epidemic and instead put onerous requirements on states that ultimately prevented individuals from accessing these needed services," said CMS Administrator Seema Verma in a statement. "The Trump Administration's approach reflects the pressing nature of the issues states are facing on the ground."

[Also: Stanford, Intermountain partner on $8.8 million project to curb opioid use]

Previously, states had been required to build out their entire delivery system for substance use disorder treatment while also meeting certain CMS standards before Medicaid demonstration approvals could be granted. The new policy will ostensibly allow states to provide greater treatment options, with the goal of improving their continuum of care over time.

Under the new demonstration policy, New Jersey will provide a comprehensive and coordinated substance use disorder benefit to adults and children while also allowing for the continuum of services provided to Medicaid beneficiaries who reside in residential treatment facilities. The services covered as part of the substance use disorder benefit will include residential treatment, withdrawal management, medication-assisted treatment, peer supports and targeted case management.

[Also: Study challenges notion that emergency departments foster opioid misuse]

Utah's program is part of a broader delivery system reform effort to address the needs of individuals with substance use disorder, those who are chronically homeless, and those within the justice system. The demonstration will also expand access to substance abuse treatment to a more complete continuum of services, including previously excluded residential treatment sites.

The new policy also is meant to turbocharge CMS' ability to evaluate how effectively the demonstration programs are working, through the collection of information and data that can be used to suss out best practices and methods to specifically combat the opioid epidemic.

A March 14 letter from the administration to governors expressed a commitment to "ensuring that states have the tools they need to combat the growing opioid epidemic that is devastating families and communities" and in developing "a more streamlined approach for substance abuse treatment."

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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