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Stephanie Pellitt

Policy and Advocacy Associate

Feds Approve West Virginia Waiver to Expand Addiction Treatment

October 12, 2017 | Addictions | Comments
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On Tuesday, West Virginia received approval from the federal government to expand addiction treatment services covered by Medicaid to include residential treatment, detoxification, methadone, naloxone, SBIRT, and peer recovery services. The waiver is intended to provide Medicaid enrollees with a more comprehensive array of addiction services and to prevent opioid overdose deaths. West Virginia is the first state to receive approval from the Trump administration to waive an important payment barrier to residential addiction treatment, known as the IMD exclusion.

Specifically, West Virginia’s Medicaid demonstration will allow for 30-day residential treatment stays starting on July 1, 2018. The demonstration further expands the substance use disorder benefit package by adding payment for: methadone treatment, peer recovery support services, withdrawal management services, the overdose-reversal drug called naloxone, and screening, brief intervention and referral to treatment (SBIRT) carried out by first responders. The waiver is funded more than 80 percent by the federal government.

Historically, the federal government has prohibited Medicaid payment for residential addiction treatment services delivered in facilities that have 16 or more beds. The rule, called the Institutes of Mental Disease (IMD) exclusion, has greatly hindered patients’ ability to seek treatment, particularly in light of the opioid epidemic. In response, many states have sought relief from this restriction through the use of 1115 Medicaid waivers. While the Obama administration approved a number of state requests to waive the IMD exclusion, this is the first such waiver to be approved by Trump administration officials.

West Virginia Senator Shelley Moore Capito (R) praised the waiver’s approval saying, “States need flexibility to customize their Medicaid programs, and, in West Virginia’s case, we need to direct resources to address our state’s deadly opioid epidemic.” West Virginia currently leads the nation in per capita deaths from opioid overdose. State officials have said this waiver is essential to reversing the tide of opioid addiction and preventing future deaths.