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CMS Announces New Opioid Policy, Approves State Demonstrations

The Centers for Medicare & Medicaid Services (CMS) announced on Nov. 1 a policy giving states the ability to pay for a fuller continuum of care to treat substance use disorders (SUD).

The policy allows a more streamlined process for states to design demonstrations that increase flexibility in treating populations affected by the opioid epidemic. CMS must approve these demonstrations through waiver authority,

In the same announcement, the agency approved waivers related to SUD treatment for New Jersey and Utah. New Jersey’s waiver lifts the institutions for mental disease exclusion in the Medicaid program, making it the sixth state to obtain a waiver to do so. This enables the use of Medicaid funding to treat patients in mental health and substance use disorder residential treatment facilities with more than 16 beds.

Utah’s demonstration will attempt to help individuals with SUD, including the chronically homeless and individuals in the justice system. It also will expand access to SUD treatment in previously excluded facilities.

The announcement came on the same day the administration’s Commission on Combating Drug Addiction and the Opioid Crisis issued a final report with recommendations to fight the epidemic. The president has declared the epidemic a public health emergency.

Contact Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Rachel Schwartz is a former policy associate at America's Essential Hospitals.

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