CMS Approves Ohio’s Substance Use Disorder Demonstration Waiver to Improve Patient Treatment Options

Left to Right: Ohio Governor Mike DeWine, U.S. Department of Health and Human Services Deputy Secretary Eric Hargan, and Centers for Medicare and Medicaid Studies Administrator Seema Verma.

(Washington, D.C.)—Ohio Governor Mike DeWine today announced that the Centers for Medicare and Medicaid Services approved Ohio’s substance use disorder (SUD) demonstration waiver to

improve patient care for Medicaid-enrolled individuals with an opioid use disorder (OUD) or other SUD. This demonstration allows Ohio to enhance residential treatment services as a crucial component in the continuum of substance use disorder benefits by permitting Ohio to receive federal funding for Medicaid services for individuals with an opioid and/or substance use disorder who temporarily live in inpatient or residential treatment facilities.

“Through this waiver, Ohio will continue to have access to substance use disorder treatment services helping our efforts to confront the opioid epidemic,” said Governor DeWine. “Over the years Ohio has tragically been hit hard with overdose deaths, but progress is being made in helping prevent, identify, treat, and support the recovery of those with substance use disorder.  Initiatives such as the SUD demonstration waiver will help us save even more lives.”

The demonstration expands efforts to implement models of care focused on increasing support for individuals in the community and home — outside of institutions — and improve access to a continuum of high-quality, evidence-based SUD services. This continuum of care is based on the American Society of Addiction Medicine criteria that reflects nationally recognized clinical treatment guidelines. During the five-year demonstration period, Ohio seeks to increase adherence to and retention in treatment while at the same time reducing the use of emergency departments and inpatient hospital settings through improved access to other continuum of care services.

“The five-year waiver provides a more comprehensive approach to care that focuses on linking those with an addiction to clinical and non-clinical recovery supports,” said Ohio Department of Medicaid Director Maureen Corcoran.

“Providers need the ability to respond to the demand for services in their communities while meeting state and federal expectations,” said Ohio Department of Mental Health and Addiction Services Director Lori Criss. “Approval of this waiver request is an important first step.  We look forward to working collaboratively with our state and local partners to implement the plan.”

Ohio’s demonstration waiver application was submitted to the Centers for Medicare and Medicaid Services in January 2019. The application was developed by Ohio Medicaid in conjunction with the Ohio Department of Mental Health and Addiction Services, and with support and assistance from CMS.

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