State expands addiction treatment for Oregon Health Plan members

PORTLAND, Ore. (KTVZ) -- The Oregon Health Authority is pleased to announce expanded care for addiction services.

On Thursday, the Centers for Medicare and Medicaid Services approved Oregon’s application for a five-year Medicaid 1115 Demonstration Waiver, which will increase access to treatment services for people with substance use disorders who are covered by the Oregon Health Plan.

Prior to the approval of the SUD waiver, any Institutions for Mental Disease could not bill services to Medicaid. IMDs are settings of more than 16 beds that are primarily engaged in providing diagnosis, treatment, or care of persons with mental diseases, including medical attention, nursing care, and related services. 

The waiver now allows federal funds to match state funds for substance use treatment for Medicaid members in an IMD. 

The waiver, which is effective through March 31, 2026, will allow Oregon to:

• Expand the continuum of care for people with substance use disorders.
• Improve access to care for substance use disorders, including outreach, initiation, treatment and recovery.
• Reduce use of emergency departments and inpatient hospital settings for treatment.
• Reduce readmissions to the same or higher level of care when the readmission is preventable or medically inappropriate.
• Increase rates of identification, initiation, and engagement in treatment for substance use disorders.
• Include housing support services in the treatment care plan.

“The new federal funding, in addition to the investment provided in the Governor’s Budget for 2021-23, will allow Oregon to accomplish our vision to prevent and identify substance use disorder and support people in sustaining long-term recovery,” said OHA Behavioral Program Director Steve Allen.

While the additional covered services will help more Oregonians, the state’s application to support people with ongoing, post-treatment, and peer recovery services with Medicaid funding was not approved. Oregon will continue to find other ways to fund this crucial component of effective treatment.

OHA Medicaid Director Lori Coyner said, “We are excited and hopeful about the opportunities to improve access for Oregon Health Plan members to important substance use treatment services.”

OHA will begin working with Coordinated Care Organizations to implement activities immediately, with the goal of implementing all new activities by January 2023.

To learn more:

More information about Oregon’s SUD 1115 Waiver, including special terms and conditions for the full waiver, can be found at: https://www.oregon.gov/oha/HSD/Medicaid-Policy/Pages/SUD-Waiver.aspx

For additional information or inquiries, please contact Substance Use Systems Coordinator and SUD 1115 Waiver Manager Joanna Johnson at sud.waiver@dhsoha.state.or.us.