Substance Use Disorder Medicaid 1115 Demonstration Application

Overview

Oregon is applying to the Centers for Medicare & Medicaid Services (CMS) for a new five-year Medicaid 1115 Demonstration waiver to help build a full continuum of care for Medicaid members with substance use disorders. 

Oregon’s vision

We believe substance use disorder is a chronic condition that needs long-term comprehensive care and support. Oregon envisions a person-centered and recovery-oriented system that supports prevention, treatment and ongoing support for sustained recovery.

Right now:

• Oregon cannot use Medicaid funds to pay for residential treatment in facilities with more than 16 beds. Most of Oregon’s residential treatment facilities are more than 16 beds and solely state-funded. 
• Only treatment is eligible for Medicaid funding (not prevention, outreach, or recovery support).

If approved, the SUD 1115 waiver would allow Oregon to pay all residential facilities using Medicaid funds. OHA will use these new funds to also provide the supports needed to prevent substance use disorder, identify substance use disorder and sustain long-term recovery.

Public process

This waiver has the potential to profoundly change Oregon’s substance use disorder treatment system. OHA will seek public comment on the waiver application starting July 2019.