Oregon SUD 1115 Demonstration Waiver Information

Oregon received approval from the Centers for Medicare & Medicaid Services (CMS) for a new five-year Medicaid 1115 Demonstration waiver to help build a full continuum of care for Medicaid members with substance use disorders. The vision for this waiver is for Oregon to offer a “full continuum of care that supports all aspects of substance use status, including positive-health - supporting freedom from substance misuse, and supporting recovery." 

  • In 2022, Oregon began receiving federal match for individuals receiving services in a residential facility with greater than 16 beds. Previously this was not allowed due to federal regulations known as the Institution for Mental Disease, or “IMD", Exclusion. 

  • As of January, 2022, housing and employment support services were added to the benefit package with corresponding billing/encounter codes. 

  • Additionally, the following services and billing/encounter codes have been implemented: brief intervention, restorative case management, crisis intervention, skills restoration, and strategic rate increases.

Future SUD Waiver Implementation activities include: 

  • Adding American Society of Addiction Medicine (ASAM) level of care to provider licensure and certification and training for culturally specific peer delivered service providers.