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Tags Posts tagged with "Medicaid"

Medicaid

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The Office of Inspector General (OIG) within the U.S. Department of Health and Human Services (HHS) has issued a favorable advisory opinion regarding contingency management (CM), an evidence-based approach for treating substance use disorders (SUD) that uses financial incentives to reward healthy behavior, such as abstinence and treatment retention, according to the National Council for Mental Wellbeing.

CM has been shown to be an effective approach for those with SUD in more than 100 randomized controlled trials over 50 years. Evidence shows it can double abstinence rates across opioids, stimulants, alcohol, tobacco, and nicotine, compared to usual care alone. It is the most effective and most evidence-based treatment for stimulant use disorders. In 2021, the Biden Administration declared advancing CM among its drug policy priorities.

The advisory opinion clears the way for CM for routine use in publicly funded substance use treatment programs and healthcare facilities under federal reimbursement, including Medicaid.

Read the full press release.

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RCPA is pleased to offer this webinar on Tuesday, January 25, 2022, at 1:00 pm to discuss moving beyond the Carve-out/Carve-in debate.

In an age of integrated care, specialty behavioral health care matters. For more than two decades, the debate of what to do in Medicaid managed care with physical health care (PH) and behavioral health care (BH) centered on the question: should a state carve-out BH from PH managed care contracts or carve-in BH to PH managed care contracts? This presentation will focus on the most current answers to that question. Please register here if you have not registered yet for this event.

Presenters include:

Panelists will review:

  • Pennsylvania’s Behavioral HealthChoices;
  • Discuss managed care models utilized in other States; and
  • Asses how the debate is changing from carve-out vs. carve-in to a focus on contractual standards and accountability.

Achieving whole-person care and addressing social determinants of health by doing specialty behavioral health care directly through various Medicaid managed care approaches will be considered. While there will be an opportunity to ask questions at the time of the presentation, we encourage you to submit questions in advance to Tina Miletic.

Please register here to attend this webinar. We look forward to your participation!

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The Pennsylvania Department of Human Services (DHS) is making available for public review and comment the proposed renewal application for the extension of the Section 1115 Medicaid Demonstration titled “Medicaid Coverage for Former Foster Care Youth from a Different State and SUD Demonstration” (Project Number: 11-W-003083/3). The effective dates of the current approved demonstration are October 1, 2017, through September 30, 2022. The extension requested will be for an additional five years, through September 30, 2027.

In 2016, the CMS Medicaid and CHIP Managed Care Final Rule eliminated Pennsylvania’s ability to use $55 million in federal funding to pay for residential SUD treatment. However, the Commonwealth was able to preserve the funding through an approved Section 1115 Waiver Demonstration. It is within this waiver that Pennsylvania committed to transitioning to ASAM Criteria as a condition for approval of the waiver.

The following links provide information regarding this extension request, extension application, public input process, schedule of public hearings, and other relevant information:

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