The Opioid Epidemic and Medicaid's Role in Facilitating Access to Treatment

Issue Brief
  1. Opioid use disorder is defined as the dependence or abuse of opioids in the past year.

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  2. Kaiser Family Foundation analysis of the 2017 National Survey on Drug Use and Health (NSDUH).

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  3. 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/.

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  4. Kaiser Family Foundation analysis of the 2017 National Survey on Drug Use and Health (NSDUH).

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  5. “Medication-Assisted Treatment (MAT),” SAMHSA (Substance Abuse and Mental Health Services Administration), available at: https://www.samhsa.gov/medication-assisted-treatment/.

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  6. 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/.

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  7. 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/,

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  8. 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).

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  9. 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.

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  10. 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/,

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  11. 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.

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  12. CMS, Strategies to Address the Opioid Epidemic, SMD #17-003 (Nov. 1, 2017), https://www.medicaid.gov/federal-policy-guidance/downloads/smd17003.pdf.

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  13. 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/.

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  14. The 30 days do not need to be consecutive. H.R. 6, § 5052 (a)(2) (creating new Social Security Act § 1915 (l)(2)).

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  15. 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/.

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  16. 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/.

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  17. 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.

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  18. 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.

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  19. “Synthetic Opioid Data,” Centers for Disease Control and Prevention, December 2018, https://www.cdc.gov/drugoverdose/data/fentanyl.html.

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