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.
This report demonstrates that the new codes have opened up opportunities for the provision of more services to our members.
For more information, please contact Michelle Brandsma at email@example.com