The Opioid Epidemic and Medicaid's Role in Facilitating Access to Treatment
Issue Brief
Opioid use disorder is defined as the dependence or abuse of opioids in the past year.
Kaiser Family Foundation analysis of the 2017 National Survey on Drug Use and Health (NSDUH).
Jarlenski, M., Barry, C. L., Gollust, S., Graves, A. J., Kennedy-Hendricks, A., & Kozhimannil, K. (2017). Polysubstance Use Among US Women of Reproductive Age Who Use Opioids for Nonmedical Reasons. American journal of public health, 107(8), 1308–1310. doi:10.2105/AJPH.2017.303825, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508143/.
Kaiser Family Foundation analysis of the 2017 National Survey on Drug Use and Health (NSDUH).
“Medication-Assisted Treatment (MAT),” SAMHSA (Substance Abuse and Mental Health Services Administration), available at: https://www.samhsa.gov/medication-assisted-treatment/.
Kathleen Gifford, et al., “States Focus on Quality and Outcomes Amid Waiver Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2018 and 2019,” (Washington, DC: Kaiser Family Foundation, October 2018), https://www.kff.org/medicaid/report/states-focus-on-quality-and-outcomes-amid-waiver-changes-results-from-a-50-state-medicaid-budget-survey-for-state-fiscal-years-2018-and-2019/.
Medicaid and CHIP Payment and Access Commission, State Policies for Behavioral Health Services Covered Under the State Plan (Washington, DC: Medicaid and CHIP Payment and Access Commission, June 2016), https://www.macpac.gov/publication/behavioral-health-state-plan-services/,
An IMD is a “hospital, nursing facility, or other institution of more than 16 beds, that is primarily engaged in providing diagnosis, treatment, or care of persons with mental diseases [sic], including medical attention, nursing care, and related services.” 42 U.S.C. § 1396d (i).
David G. Smith and Judith D. Moore, Medicaid Politics and Policy, at 188-89 (2008); see also CMS Medicaid Manual § 4309 (A)(2), https://www.cms.gov/Regulations-and-Guidance/guidance/Manuals/Paper-Based-Manuals-Items/CMS021927.html.
Julia Paradise and MaryBeth Musumeci, “CMS’s Final Rule on Medicaid Managed Care: A Summary of Major Provisions,” Kaiser Family Foundation, accessed April 2018, https://www.kff.org/medicaid/issue-brief/cmss-final-rule-on-medicaid-managed-care-a-summary-of-major-provisions/,
CMS, New Service Delivery Opportunities for Individuals with a Substance Use Disorder, SMD #15-003, (July 27, 2015), https://www.medicaid.gov/federal-policy-guidance/downloads/smd15003.pdf.
CMS, Strategies to Address the Opioid Epidemic, SMD #17-003 (Nov. 1, 2017), https://www.medicaid.gov/federal-policy-guidance/downloads/smd17003.pdf.
Elizabeth Hinton, MaryBeth Musumeci, Robin Rudowitz, Larisa Antonisse, and Cornelia Hall, “Section 1115 Medicaid Demonstration Waivers: The Current Landscape of Approved and Pending Waivers,” (Washington, DC: Kaiser Family Foundation, February 2019), https://www.kff.org/medicaid/issue-brief/section-1115-medicaid-demonstration-waivers-the-current-landscape-of-approved-and-pending-waivers/.
The 30 days do not need to be consecutive. H.R. 6, § 5052 (a)(2) (creating new Social Security Act § 1915 (l)(2)).
H.R. 6, § § 5051-5052; see also Kaiser Family Foundation, Federal Legislation to Address the Opioid Crisis: Medicaid Provisions in the SUPPORT Act (Oct. 2018), https://www.kff.org/medicaid/issue-brief/federal-legislation-to-address-the-opioid-crisis-medicaid-provisions-in-the-support-act/.
Kaiser Family Foundation, “Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State,” (Washington, DC: Kaiser Family Foundation, April 18, 2019), https://www.kff.org/medicaid/issue-brief/medicaid-waiver-tracker-approved-and-pending-section-1115-waivers-by-state/.
Tami L. Mark, et al., “Insurance Financing Increased For Mental Health Conditions But Not For Substance Use Disorders, 1986-2014,” Health Affairs 35, no. 6 (June 2016):958-965.
Substance Abuse and Mental Health Services Administration. Projections of National Expenditures for Treatment of Mental and Substance Use Disorders, 2010–2020. HHS Publication No. SMA-14-4883. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014, https://store.samhsa.gov/system/files/sma14-4883.pdf.
“Synthetic Opioid Data,” Centers for Disease Control and Prevention, December 2018, https://www.cdc.gov/drugoverdose/data/fentanyl.html.