Substance Use Disorders Resources

Substance use disorders (SUD) impact the lives of millions of Americans in the general population, including individuals that are enrolled in the Medicaid program.

Many states have included behavioral health services for individuals with SUD in their Medicaid State Plans, Managed Care Waivers and Section 1115 Demonstrations. The following resources are available to states:

• State Health Official Letter: Mandatory Medicaid State Plan Coverage of Medication-Assisted Treatment - December 2020
  • Medication Assisted Treatment (MAT) (1905(a)(29)) SPA Preprint
    • Alternative format SPA Preprint (MS Word fillable form)
    • Alternative format SPA Preprint (PDF fillable form)
• State Medicaid Director Letter: Permanent Extension of Mandatory Medicaid State Plan Coverage of MAT/ Medications for Opioid Use Disorder (MOUD) – November 2024
• CMCS Informational Bulletin: Support for Family-Focused Residential Treatment-Title IV-E and Medicaid Guidance – October 2020
• CMCS Informational Bulletin: Guidance to Improve Care for Infants with Neonatal Abstinence Syndrome and Their Families – September 2020
• State Medicaid Director Letter: SUPPORT Act – Medical Assistance For Eligible Individuals Who Are Patients In Eligible Institutions for Mental Diseases (IMD) State Plan Option – November 2019
  • Medical Assistance for Certain Individuals Who are Patients in Certain IMDs SPA Preprint (1915(l)) SPA Preprint
    • Alternative format SPA Preprint (MS Word fillable form)
• CMCS Informational Bulletin: Help for Moms and Babies -Medicaid Coverage for services to Pregnant/Post-partum Women Outside of an IMD (Section 1012)
• CMCS Informational Bulletin: SPA Residential Pediatric Recovery Center – Guidance to States (Section 1007)
• Report to Congress: SUPPORT Act Section 1018: Action Plan
• CMCS Informational Bulletin: Neonatal Abstinence Syndrome: A Critical Role for Medicaid in the Care of Infants
• State Medicaid Director Letter: Leveraging Medicaid Technology to Address the Opioid Crisis
• State Medicaid Director Letter: Strategies to Address the Opioid Epidemic
• CMCS Informational Bulletin: Best Practices for Addressing Prescription Opioid Overdoses, Misuse and Addiction
• CMCS Informational Bulletin: Coverage of Behavioral Health Services for Youth with Substance Use Disorders
• CMCS Informational Bulletin: Delivery Opportunities for Individuals with a Substance Use Disorder
• CMCS Informational Bulletin: Medication Assisted Treatment for Substance Use

Coverage and Delivery of Adult Substance Abuse Services in Managed Care

This issue brief explores state strategies with respect to purchasing substance abuse services for adult Medicaid beneficiaries, with a particular focus on states that use man­aged care for the purchase and delivery of physical health services. The brief reviews the current landscape of substance abuse coverage in Medicaid managed care states and the paradigm shift created by the ACA Medicaid expansion in terms of substance abuse eligibility, benefits, and provider capacity. A webinar on this topic was held on September 24, 2014.