Medicaid to Allow Coverage for SUD Treatment for Incarcerated Individuals: Updated HHS Guidance for Medicaid Reentry Section 1115 Demonstration

On April 17, 2023, the Center for Medicare and Medicaid Services (CMS) and the Department for Health and Human Services (HHS) formally implemented the New Medicaid Reentry Section 1115 Demonstration. This update allows state Medicaid programs to cover various services for incarcerated individuals, including substance use disorder treatment. Coverage is limited to individuals within 90 days of their expected release. In January 2023, California became the first state to submit this waiver and offer services and CMS and HHS are urging other states to participate. The updated guidance builds upon the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act and aims to address health disparities present in incarcerated individuals and promote a successful reentry to society. HHS Secretary Xavier Becerra commented on the updated guidance, saying, “The Biden-Harris Administration has made expanding access to high-quality, affordable health care a top priority… We are committed to ensuring all Americans have the peace of mind they deserve knowing they have access to life-saving health care, whether it is medication-assisted treatment for substance use disorders or prescription medication to treat other chronic health conditions. Through this historic new effort, we are working to ensure that formerly incarcerated people can transition back into the community with the health care supports and services they need. This is an essential step for advancing health equity in our nation, and we encourage all states to take advantage of this new opportunity.”

Articles & Resources

HHS – HHS Releases New Guidance to Encourage States to Apply for New Medicaid Reentry Section 1115 Demonstration Opportunity to Increase Health Care for People Leaving Carceral Facilities

CEPOP – Weekly Opioid Policy Report (Week of February 27, 2023), Medicaid to Allow Coverage for SUD Treatment for Incarcerated Individuals

CMS—HHS Approves California’s Medicaid and Children’s Health Insurance Plan (CHIP) Demonstration Authority to Support Care for Justice-Involved People

Public Law 115-271 – Substance Use-Disorder Prevention that Promotes Recovery and Treatment for Patients and Communities Act (2018)

CDC Study Highlights Association of Mental Health Conditions and Experiences with Postpartum Substance Use

Published on April 21, 2023, the Center for Disease Control (CDC) researchers authored a study on the association between certain mental health conditions and experiences with postpartum opioid use. In 2019, the Pregnancy Risk Assessment Monitoring System (PRAMS) recontacted 1,990 respondents in high opioid overdose states, 9-10 months, after giving birth to evaluate reasons for postpartum opioid use. The study asked questions about opioid use, tobacco use, alcohol use, and opioid prescriptions following birth. Of the 1,920 respondents who provided data on postpartum substance use, over 25% reported postpartum substance use and nearly 7% reported polysubstance use. The data showed that individuals with depressive symptoms, depression, anxiety, more than four household dysfunction experiences in childhood, or more than six stressful experiences in the year before giving birth were twice as likely to use opioids postpartum. The study urges more robust prenatal and postpartum care, which includes screening and treatment for mental health and substance use disorders to address postpartum substance use and overdose.

Articles & Resources

CDC – Association of Mental Health Conditions, Recent Stressful Life Events, and Adverse Childhood Experiences with Postpartum Substance Use – Seven States, 2019-2020

What We Read Last Week

Several articles were published last week pertaining to the opioid epidemic, covering a variety of different components of the topic. Links to relevant articles are provided below.

AP—States Restrict ‘Tranq,’ Animal Sedative Linked to Overdoses

Axios – Why More States Are Decriminalizing Fentanyl Test Strips

Brookings —The Economic Impact of the Opioid Epidemic

Congressional Budget Office—Budgetary Effects of Policies to Modify or Eliminate Medicaid’s Institutions for Mental Disease Exclusion

JAMA Network Open – Effectiveness of Conditioned Open-Label Placebo with Methadone in Treatment of Opioid Use Disorder: A Randomized Clinical Trial

Pharmacy Times—Study: Link Seen Between Children Exposed to Opioids During Pregnancy, Chronic Diseases

STAT – FDA’s New Plan to Study Opioids’ Effectiveness Faces Resistance

University of Arizona – Stimulating the Brain to Treat Pain and Substance Use Disorder

University of Kentucky – UK Dentistry, Pharmacy Researchers Partner on Opioid Alternatives for Adolescent Pain Management

White House – Joint Statement from Canada, Mexico and the United States Following the First North America Trilateral Fentanyl Committee Meeting

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