The Centers for Medicare & Medicaid Services (CMS) approved West Virginia’s Section 1115 demonstration waiver to strengthen substance use disorder care for Medicaid beneficiaries.

The five-year demonstration project, beginning Jan. 1, 2018, allows the state to waive the institutions for mental disease (IMD) exclusion, which precludes Medicaid reimbursement for inpatient treatment furnished in an IMD with more than 16 beds. Additionally, the state will enact a comprehensive strategy to combat prescription drug misuse and opioid use disorders through a full continuum of care, including:

  • methadone treatment services;
  • peer recovery support services; and
  • withdrawal management services.

The waiver is the first of its kind granted during the Trump administration. Several other states have requested approval for similar demonstrations to fight the opioid crisis.

Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with additional questions.