Substance Use Disorder (SUD) Waiver

DHHR Begins Phase One of the Federal Waiver to Treat Substance Use

The West Virginia Department of Health and Human Resources (DHHR), Bureau for Medical Services today announced Medicaid recipients will begin receiving the first phase of new services under the West Virginia 1115 Substance Use Disorder (SUD) Waiver. The new services for Medicaid enrollees began January 14, 2018 and are part of an ongoing effort of Governor Jim Justice's Administration to provide a continuum of care designed to treat substance use issues.

In October 2017, the Medicaid 1115 Waiver was awarded to DHHR by the U.S. Centers for Medicare and Medicaid Services (CMS) to improve care and health outcomes by expanding services for those with a substance use disorder diagnosis.

"Considering West Virginia has the highest overdose rate in the nation, we are excited to offer the first phase of services from our federal waiver," said Cindy Beane, Commissioner of DHHR's Bureau for Medical Services. "Governor Justice has charged us with tackling this epidemic and these services will enable us to more effectively prevent and treat substance use disorders for Medicaid enrollees."

Services which began January 14, 2018 include:
  • Screening, Brief Intervention, and Referral to Treatment (SBIRT):  West Virginia will implement statewide use of the widely-accepted SBIRT screening tool to identify SUD treatment needs among the Medicaid population.
  • Methadone treatment and administration:  The state will add Medicaid coverage of methadone as a withdrawal management strategy, as well as the administration and monitoring of the medication, and related counseling services.
  • Naloxone Distribution Initiative:  West Virginia will design and implement a statewide initiative to make naloxone (Narcan®) widely available and increase
    awareness of the benefits of naloxone in reversing the effects of an overdose.

1115 Waiver Disorders Demonstration Waiver Approved Application  (Approved October 6, 2017, effective date January 1, 2018)
Chapter 504 Substance Use Disorder Services
SUD Waiver Emergency Medical Services (EMS) Presentation
Group Therapy Variance Memorandum

Resources


SUD Waiver services will be implemented in two phases:

Phase 1

Began on January 14, 2018 and includes statewide emplementation of the use of Screening, Brief Intervention and Referral to Treatment (SBIRT) tool to identify SUD treatment needs, reimbursement for Naloxone and Methadone treatment
coverage.

Phase 2

Begins July 2018 and includes reimbursement for all levels of short-term residential treatment, peer recovery support services and withdrawal management.

   

Contact Information:
If you would like to contact the SUD Waiver office please call 304-558-1700 or email BMSSUDWaiver@wv.gov.

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