State gets waiver to use Medicaid funds to treat addiction at private mental health centers

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Dr. Carol Odom Walker, DHSS secretary.

The Delaware Department of Health and Social Services gained approval from the Centers for Medicare and Medicaid Services for a waiver amendment.

The wavier allows DHSS to use federal Medicaid funding addiction-related treatment of individuals in substance use disorder treatment facilities.

Before the waiver, Delaware’s Medicaid program used state funds to pay for addiction-related services provided to Medicaid clients at .the mental health treatment facilities.

There are four facilities in Delaware that provide addiction-related services – Sun Behavioral Delaware near Georgetown; Dover Behavioral Health in Dover; MeadowWood Behavioral Health near New Castle; and Rockford Center near Newark.

Delaware was the 25th state to receive approval of the substance abuse waiver by the feds. Previously, federal Medicaid funds could not be used to pay for addiction-related services at IMDs (institutions for mental disease) for individuals ages 21 to 64.

The exclusion, which prohibits the use of federal Medicaid funds for care provided to most patients in mental health and substance use disorder residential treatment facilities with more than 16 beds, had been part of Medicaid since its enactment in 1965. Delaware’s waiver applies only to addiction-related services for Medicaid clients.

“We are grateful to CMS for granting us this waiver,” said DHSS Secretary Dr. Kara Odom Walker. “In the midst of the opioid crisis we are facing in Delaware and across the country, the IMDs are another resource we can use to better serve our Medicaid clients in need of treatment for substance use disorder.”

DHSS’ Division of Medicaid and Medical Assistance (DMMA) also received approval from CMS for an extension of its Medicaid demonstration project, Diamond State Health Plan, along with its substance abuse waiver amendment. Both approvals are effective from Aug. 1, 2019, through Dec. 31, 2023.

“We are very pleased to have the approval of our demonstration waiver and the added SUD expenditure authority,” Delaware Medicaid Director Steve Groff said. “This will allow all Medicaid beneficiaries in Delaware to have access to high-quality SUD care.”

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