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Indiana Family and Social Services AdministrationOffice of Medicaid Policy and Planning
1115 SUD Waiver
Post-Approval Public Meeting
July 19, 2018
Expanded SUD Treatment
Expanded SUD Treatment
February 1, 2018:
Inpatient stays in institutions for mental disease (IMDs) available for all Indiana Health Coverage Programs (IHCP) members
March 1, 2018:
Residential SUD treatment available for IHCP members
Expanded SUD Treatment
Substance Use Disorder
Total Number of Medicaid Population with a SUD Services As of Date: Jul 8, 2018
Analysis Period : March-2018 Thru July-2018
Substance Use Disorder Service: All Services
Services Recipient Count Claim Count Amount
Medication Assisted Treatment 4,112 54,972 $5,073,165.18
Early Intervention 118 129 $2,678.69
Outpatient Services 17,281 246,277 $28,115,831.31
Intensive Outpatient Services 375 2,362 $137,781.00
Partial Hospitalization 1 1 $219.86
Low-Intensity Residential 1 9 $4,679.02
High-Intensity Residential 46 204 $152,704.65
Inpatient 1,669 1,879 $9,374,324.58
Total 23,603 305,833 $42,861,384.29
Expanded SUD Treatment
Future State:
Late 2018/Early 2019 – Expand peer recovery benefit
Certification and Assessment
Standards
Certification Standards
February 1, 2018:
Launched the ASAM Level 3.1 and 3.5 designation process
Results:
• Level 3.1 – 7 units designated
• Level 3.5 – 20 units designated
Future State:
Continue DMHA certification standards update
Assessment Standards
August 2018 (tentative):
Include additional questions in the Adults Needs and Strengths Assessment (ANSA) around SUD treatment
Future State:
Continue to develop an updated ANSA scoring system to incorporate appropriate ASAM level of treatment
Communication Activity
Communication Activity
Site Visits (Discussions):
Salvation Army Harbor House
Hickory House
Life Treatment Centers
YMCA
Southwestern Behavioral Health
BT201821 – FAQ for residential treatment
BT201827 – Correction to FAQ
CMS Administrative Activity
CMS Administrative Activity
Implementation Protocol:
Approved February 1, 2018
Health Information Technology Protocol:
Approved June 6, 2018
Monitoring Protocol:
Submitted April 30, 2018
CMS Administrative Activity
Evaluation Protocol:
Independent Evaluator: Burns & Associates
Will be submitted by July 31, 2018
Quarter 1 2018 Progress Report:
Submitted May 31, 2018
Overall Concerns
Overall Concerns
Low number of ASAM Level 3.1 providers
Complaints around varying prior authorization criteria among the MCEs
Overall education on the prior authorization
process
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