Substance Use Disorder Section 1115 Demonstration Waiver

Summary and Background

On September 24th, 2019, The Centers for Medicare and Medicaid Services (CMS) approved Ohio’s substance use disorder (SUD) demonstration waiver to support a comprehensive continuum of care for Medicaid-enrolled individuals with an opioid use disorder (OUD) or other SUDs. The demonstration expands Ohio’s efforts to increase support for individuals in the community and home — outside of institutions — and improve access to a continuum of high-quality, evidence-based SUD services based on clinical guidelines set by the American Society of Addiction Medicine (ASAM).

During the five-year demonstration period, Ohio seeks to:

  • Increase rates of identification, initiation, and engagement in treatment for SUD
  • Increase adherence to and retention in treatment
  • Reduce overdose deaths, particularly those due to opioids
  • Reduce use of emergency departments and inpatient hospital settings for treatment when the utilization is preventable or medically inappropriate through improved access to other continuum of care services
  • Reduce readmissions to inpatient hospital settings or higher level of care when the readmission is preventable or medically inappropriate
  • Improve access to care for physical health conditions among individuals with an SUD

“Through this demonstration, Ohio maintains essential access to SUD treatment services during a critical time in Ohio’s efforts to confront the opioid epidemic,” said Maureen Corcoran, director of the Ohio Department of Medicaid.

A central part of the SUD 1115* demonstration waiver focuses on enhancing residential treatment services as a crucial component in the continuum of SUD benefits by permitting Ohio to receive federal funding for Medicaid services for individuals with an OUD and/or SUD who temporarily reside in inpatient or residential treatment facilities.

This webpage will serve as the central repository of information and communication related to Ohio’s SUD 1115 SUD Waiver.

 


 


Approval documents from CMS and the Governor's Office news release are available below:


Questions regarding the waiver may be submitted via email to MCD_SUD1115@medicaid.ohio.gov.


November 6th SUD 1115 Waiver Stakeholder Briefing - View Presentation | View Webinar Recording

OhioMHAS and ODM held a stakeholder briefing on November 6th regarding Ohio’s recently approved Medicaid demonstration waiver supporting a comprehensive continuum of services for Medicaid enrolled individuals with substance use disorders.

The briefing provided an overview of Ohio’s approved SUD 1115 Waiver, its major milestones, and proposals for how to obtain meaningful stakeholder input throughout the waiver’s 5-year life.


Additional Resources