Health Affairs November 1, 2024
Abstract
A long-standing policy prohibits the use of federal funds for Medicaid services in Institutions for Mental Diseases (facilities with more than sixteen beds that specialize in mental health or substance use disorder treatment). Beginning in 2015, states could apply for Section 1115 Medicaid waivers, which permit federal funding for Institutions for Mental Diseases services and require improvements in opioid use disorder (OUD) treatment. Using 2016–20 Medicaid data, we compared changes in the use of medications for OUD and nonfatal overdoses in seventeen states with waivers approved during 2017–19 to changes in eighteen states without waivers. Waiver implementation was not associated with improvements in overall medication...
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