ASAM Applauds Enactment of Important Medicaid Measures That Will Enhance Access to Addiction Treatment

FOR IMMEDIATE RELEASE

March 9, 2024

Rockville, MD - Today, the American Society of Addiction Medicine (ASAM) applauded Congress for including important Medicaid measures supporting addiction treatment in its first Fiscal Year 2024 minibus package. Signed into law today by President Biden, the Consolidated Appropriations Act, 2024, will enhance Americans’ access to evidence-based addiction treatment at a time when overdose deaths are near record highs. 

The legislation, reflecting an agreement on six of twelve FY 2024 appropriations bills, includes the following key Medicaid provisions:

• permanently requiring state Medicaid programs to cover all forms of medications for the treatment of OUD, including methadone, along with counseling services and behavioral therapy;
• making permanent the SUPPORT Act of 2018’s state plan amendment option that allows state Medicaid programs to cover SUD treatment at inpatient or residential substance use disorder treatment programs - with over 16 beds - for up to 30 days per year, per beneficiary.  The following requirements will apply, beginning October 1, 2025:
• the State must have in place evidence-based, substance use disorder-specific individual placement criteria and utilization management approaches to ensure placement of eligible individuals in an appropriate level of care, including criteria and approaches to ensure that eligible individuals receive appropriate evidence-based clinical screening prior to being furnished with items and services in an eligible institution for mental diseases, including initial and periodic assessments to determine the appropriate level of care, length of stay, and setting for such care for each individual;
• the State must notify the Secretary of the Department of Health and Human Services (HHS) at such time and in such form and manner as they shall require of such criteria and utilization management approaches; and
• the State must, using nationally recognized substance use disorder-specific program standards, have in place a process to review the compliance of eligible institutions for mental diseases with such program standards specified by the State.
• prohibiting States from terminating Medicaid enrollment based on incarceration, beginning January 1, 2026;
• appropriating $113,500,000 for grants to States addressing operational barriers to promote continuity of care for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries following incarceration; 
• mandating HHS guidance to States on improving the behavioral health workforce and integration of care under Medicaid and CHIP within 24 months of enactment; and
• codifying a Medicaid definition for Certified Community Behavioral Health Centers (CCBHCs).

The legislation also includes provisions to mitigate approximately half of the 3.4% pay cut in the Medicare fee schedule that became effective on January 1. The 1.68% increase in current payment levels will take effect today, March 9, and continue through 2024. 

Congress has released the following minibus summaries:

• Senate Majority: summary
• Senate Minority: summary
• House Majority: summary
• House Minority: summary

Congressional leaders plan to pass the remaining six bills by March 22.

The Centers for Disease Control and Prevention (CDC) predicts 111,380 drug overdose deaths between September 2022 and September 2023. In addition to the heartbreaking loss of human life, the opioid addiction and overdose crisis has cost the United States $1.5 trillion in 2020 alone, according to a September report published by the U.S. Congress’ Joint Economic Committee.

ASAM eagerly anticipates collaboration with the Administration and Congress to build on today’s progress, focusing on strengthening the addiction treatment workforce, closing the Medicare coverage gap for residential substance use disorder services, and responsibly increasing access to methadone treatment for opioid use disorder.

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About the American Society of Addiction Medicine  

The American Society of Addiction Medicine (ASAM), founded in 1954, is a professional medical society representing over 7,000 physicians, clinicians, and associated professionals in the field of addiction medicine. ASAM is dedicated to increasing access and improving the quality of addiction treatment, educating physicians and the public, supporting research and prevention, and promoting the appropriate role of physicians in the care of patients with addiction. For more information, visit www.ASAM.org.