AUGUSTA — The Maine Department of Health and Human Services announced Tuesday the federal government has approved the State's request to expand substance use disorder (SUD) treatment options for MaineCare members, improving access to and quality of SUD treatment in Maine and advancing DHHS' work to bridge medical and behavioral health care.

The U.S. Centers for Medicare and Medicaid Services (CMS) approved DHHS’ 1115 demonstration waiver application, allowing federal Medicaid reimbursement for SUD treatment in facilities with more than 16 beds.

Approval of this waiver allows residential SUD treatment facilities to serve more Maine people with SUD by adding more treatment slots and supporting new SUD providers in beginning to serve MaineCare members, per a news release. 

"This waiver advances our broader work to prevent Substance Use Disorders and ensure that Maine people have access to high-quality services at all stages of treatment," said DHHS Commissioner Jeanne Lambrew. "Additional residential treatment options will improve our system of care and get Maine people the help they need during this challenging time."

"The receipt of this waiver will lead to more residential options for Maine people with substance use disorders in the near future," said Gordon Smith, Maine's Director of Opioid Response. "This initiative could not come at a more important time, as we continue to take action to help people with SUD during this pandemic."

Residential treatment facilities provide intensive programs that help individuals with SUD through the substance use withdrawal period and establish them in treatment. Some of these programs are tailored to specific populations, such as women or families.

Maine will begin implementing this waiver in February 2021, joining 29 other states. Under the waiver, states can waive the long-standing federal "Institutions for Mental Disease (IMD) Exclusion," which prohibits the use of federal Medicaid funds for care provided to adult patients in mental health and SUD residential treatment facilities larger than 16 beds.

DHHS continues to reach out to providers about this opportunity to expand SUD services for MaineCare members, with several indicating that they would be ready to expand their capacity within three to six months.

Maine's goals for this initiative, however, extend beyond supporting residential SUD treatment facilities to serve additional members. DHHS aims to improve access to and quality of treatment for all adult MaineCare members with SUD, with a focus on increasing engagement in SUD treatment, especially in community settings; reducing overdose deaths, particularly those due to opioids; reducing preventable or medically inappropriate hospital visits; and improving access to care for physical health conditions among MaineCare members receiving SUD treatment.

This waiver adds to other SUD-related efforts MaineCare has underway. This includes the Maine Maternal Opioid Misuse Model to improve care for pregnant and postpartum women with Opioid Use Disorder (OUD) and their infants by integrating maternal and substance use treatment services; SUPPORT for ME, which aims to increase MaineCare providers' ability to deliver SUD treatment and recovery services through technical assistance and support; and enhancing MaineCare's Opioid Health Home program to improve members' access to OUD treatment while promoting evidence-based treatment and encouraging integration with primary care.

To combat the disturbing rise in fatal drug overdoses exacerbated by the COVID-19 pandemic, Maine also launched in October the "OPTIONS" (Overdose Prevention Through Intensive Outreach, Naloxone and Safety) initiative. Under the initiative, mobile response teams in every Maine county engage with communities that have high rates of drug overdoses to promote drug prevention and harm reduction strategies, connect people directly to recovery services and treatment, and distribute naloxone, the lifesaving overdose medication.