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Substance Use Disorder (SUD) Waiver

​​The West Virginia Department of Human Services (DoHS) Bureau for Medical Services has announced Medicaid recipients will begin receiving the second phase of new services under the West Virginia 1115 Substance Use Disorder (SUD) Waiver. The new services for Medicaid enrollees began on July 1, 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. 
For information regarding Section 1115 Demonstration, please click here.​ 
Phase two services, which began on July 1, 2018, expanded coverage to included:
  • Adult Residential Treatment:  West Virginia added ​Medicaid coverage of adult residential treatment levels adhering to the American Society of Addiction Medicine (ASAM) criteria. These are comprehensive programs for adults ages 18 and older who have a diagnosis of substance abuse and/or co-occurring substance abuse/mental health disorder.
  • Peer Recovery Support Services:  West Virginia implemented peer recovery support services delivered by a trained and certified peer recovery specialist who has been successful in their own recovery process and can extend the reach of treatment beyond the clinical setting into a member's community and home environment.
  • Withdrawal Management Services:  West Virginia offers coverage of withdrawal management services. This licensed program provides short-term medical services on a 24- hour basis for stabilizing intoxicated members, managing their withdrawal and facilitating access to SUD treatment as needed by a comprehensive assessment.
"The addition of adult residential treatment, peer recovery support services and withdrawal management services expands the Medicaid benefits package to build a comprehensive statewide strategy to combat drug misuse and substance use disorders," said Cindy Beane, Commissioner of DoHS' Bureau for Medical Services. "Governor Justice's Administration continues to support the expansion of high quality SUD care and the expansion of SUD provider networks to serve the State's Medicaid population."

Phase one services, effective January 14, 2018, included:
  • Screening, Brief Intervention, and Referral to Treatment (SBIRT):  Implemented statewide use of the widely-accepted SBIRT tool to identify SUD treatment needs among the Medicaid population.
  • Methadone treatment and administration:  Added 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:  Implemented a statewide initiative to make naloxone widely available and increase awareness of the benefits of naloxone in reversing the effects of an overdose.

Contact Information

For more information on SUD Waiver Services, please call 304-558-1700.