HEALTH CARE AUTHORITY
[Filed January 11, 2021, 9:40 a.m.]
Title or Subject: Medicaid State Plan Amendment (SPA) 21-0007 Medication Assisted Treatment for Opioid Use Disorder.
Effective Date: October 1, 2020.
Description: The health care authority (HCA) intends to submit medicaid SPA 21-0007 in order to adjust state plan language placement specific to coverage of medication assisted treatment for opiate use disorders (MAT) following recent Centers for Medicare and Medicaid Services guidance.
Section 1006(b) of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (herein referred to as the SUPPORT Act) (Pub. L. No. 115-271) now requires states to provide medicaid coverage of certain drugs and biological products and related counseling services and behavioral therapy as a mandatory benefit during the period from October 1, 2020, through September 20, 2025.
These services were previously covered under the medicaid state plan as an approved optional service. This SPA moves the location within the state plan to the required mandatory benefit section and also specifies the reimbursement methodology shared with all drug purchasing as required. These changes will have no impact to providers at this time.
SPA 21-0007 is expected to have no impact on the annual aggregate expenditures/payments for medicaid coverage of MAT-related drugs and biological products and related counseling services and behavioral therapy.
SPA 21-0007 is in the development process; therefore a copy is not yet available for review. HCA would appreciate any input or concerns regarding this SPA. To request a copy when it becomes available or submit comments, you may contact the person named below (please note that all comments are subject to public review and disclosure, as are the names of those who comment).
Contact David Johnson, Federal Programs Manager, Division of Behavioral Health and Recovery Federal Program, P.O. Box 42730, Olympia, WA 98504-2730, phone 360-764-3179, TTY 711, fax 360-763-4702, email firstname.lastname@example.org, website www.hca.wa.gov.