Evaluating the role of Section 1115 waivers on Medicaid coverage and utilization of opioid agonist therapy among substance use treatment admissions

Abstract

Objective To examine the impact of Section 1115 waivers on Medicaid coverage and opioid agonist therapy (OAT) utilization among substance use treatment admissions. Data Source Treatment Episode Data Set‐Admissions (TEDS‐A) (2001‐2012). Study Design We examined effects of 1115 waiver implementation on proportions of substance use treatment admissions with Medicaid and receiving OAT, using random intercept linear regression. Principal Findings 1115 waiver implementation was associated with an average of a 6 percentage point increase in proportion of all admissions with Medicaid, and 4 percentage point increase among opioid outpatient admissions. Implementation was not associated with change in proportion of opioid outpatient admissions receiving OAT. Conclusions 1115 waivers influence Medicaid coverage among substance use treatment admissions. The findings improve our understanding of how state policies impact substance use treatment utilization.

Shifting Medication Treatment Practices in the COVID-19 Pandemic: A Statewide Survey of Pennsylvania Opioid Treatment Programs

“…Medications for opioid use disorder (MOUD), especially methadone and buprenorphine, are highly effective and reduce risk of opioid overdose by over 50%. 7 , 8 However, accessing MOUD in the U.S., especially methadone, has been historically difficult as federal regulations require that methadone be dispensed by licensed opioid treatment programs (OTPs). 9 , 10 OTPs require patients make near-daily visits to OTPs in the first 90 days and at least weekly visits in the first year of treatment.…”

Association of Medicaid expansion and 1115 waivers for substance use disorders with hospital provision of opioid use disorder services: a cross sectional study

“…Similarly, outpatient SUD providers in expansion states were more likely to offer psychiatric medications [ 9 ], and Medicaid expansion was associated with a 43 percent increase in Medicaid-reimbursed prescriptions for medications to treat SUDs [ 10 ]. Additionally, state implementation of a SUD-related Medicaid 1115 waiver was associated with an increase in the proportion of outpatient admissions for opioid treatment insured by Medicaid in the state, as well as an increase in the proportion of patients receiving medication for OUD (MOUD) in outpatient facilities [ 11 , 12 ].…”