CMS approves Medicaid waivers for opioid treatment in 2 states

Utah and New Jersey are the first states approved by CMS to design demonstration projects allowing Medicaid to pay for opioid addiction treatment, including enrollees residing in residential treatment facilities.

Utah’s waiver will expand Medicaid to treat 4,000 to 6,000 childless adults in the state.

“Today's announcement allows us to address the specific challenge of extending health care coverage — including substance abuse and mental health services — to the homeless population,” Utah Gov. Gary Herbert said in a statement. “I commend the Trump administration for approving our waiver request, and look forward to providing these critical services.”

The governor’s press release said enrollment for patients made eligible for Medicaid under the waiver will begin immediately.

New Jersey’s waiver will allow it to use Medicaid funds to provide “comprehensive and coordinated” substance abuse treatment, including residential withdrawal management treatment and medication-assisted treatment (MAT). New Jersey Gov. Chris Christie is the head of the White House opioid commission which recommended increasing access for MAT as part of its report on ways to tackle the opioid abuse epidemic.

The state had already taken other actions to tackle its growing opioid problem with at least 1,900 people in New Jersey having died from overdoses in 2016. A recently enacted state law allowed pharmacies without medical directors to apply for a standing order to dispense Narcan, which can reverse the effects of opioid overdoses, without a prescription.

Brian Neale, director of the Center for Medicaid and CHIP Services, encouraged other states to submit Section 1115 waivers in a letter to all 50 state Medicaid directors.

“As the opioid crisis continues to raise alarm and highlight the need for better access to high quality, evidence-based treatment, CMS would like to partner with states to support ways to progressively improve outcomes for Medicaid beneficiaries struggling with addiction in the context of 5-year demonstrations,” Neale wrote. “In addition to these efforts, CMS will ensure states take significant steps to prevent inappropriate prescribing of opioids for Medicaid beneficiaries.”

Not all parts of the proposed waivers were approved. Utah’s waiver originally included a controversial work requirement for Medicaid beneficiaries that has been proposed by Republicans at both the state and federal level.