Waiver amendment allows Washington State to better serve people with opioid and other substance use disorders
The
Washington State Health Care Authority (HCA) announced today final federal
approval of an amendment to the state's Medicaid Transformation waiver,
ensuring the state can continue treating substance use disorders in the most
appropriate way.
The
Centers for Medicare & Medicaid Services (CMS) approved HCA's request to
receive federal Medicaid funding for services provided to Apple Health
(Medicaid) clients to treat opioid addiction and other substance use disorders
when those services are offered in facilities called institutions for mental
disease (IMD).
Federal
rules restrict the use of Medicaid funds for treatment in IMDs, defined as
facilities larger than 16 beds and primarily engaging in the treatment of
mental health or substance use disorders. Several inpatient and mental health
and residential facilities in Washington State are considered IMDs, and
approval of this amendment allows the state to maintain and expand access to
inpatient and residential treatment.
The
amendment applies to Washington State's existing Section 1115 waiver, known as
Healthier Washington Medicaid Transformation. The five-year effort launched
in January 2017 and provides up to $1.1 billion of incentives for rewarding
high-quality care. It takes a patient-centered, holistic approach to care,
creates partnerships among community organizations, and adds support systems
for older adults, people with chronic homelessness and joblessness, and family
caregivers.
"This
amendment to Washington State's Medicaid Transformation effort will help save
lives," said MaryAnne Lindeblad, HCA's Medicaid Director. "Improving the health
of our populations through better substance use disorder treatment is
fundamental to improving the social well-being of our citizens. This enables us
to provide even more support to all areas of the state to improve care and
ensure the right services reach all of our communities."
"I
congratulate Governor Inslee and his team for crafting a comprehensive strategy
that will improve health outcomes for Medicaid beneficiaries by increasing
access to high quality care to combat substance use abuse," said CMS
Administrator Seema Verma. "Washington is the 11th state in the last nine
months to gain federal approval for this important tool in the fight against
the opioid crisis."
Additionally,
CMS approved the state's substance use disorder implementation plan protocol, which
outlines Washington's path to provide care for Medicaid beneficiaries with
opioid use disorder and other substance use disorders. The implementation plan describes
the requirements and milestones that the state will follow in order to
accomplish the goals of the amendment. Other technical corrections to existing
special terms and conditions were also included in the approval.
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