An update on Alaska’s 1115 waiver

A recent DHSS update on Alaska’s 1115 Behavioral Health Medicaid waiver points to a July 1 implementation date for the waiver’s substance use disorder component. Enhanced SUD service coverage will begin on the first of the month, with a regional phase in.


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Alaska submitted its 1115 waiver to the Centers for Medicare and Medicaid Services (CMS) for approval in January 2018. The waiver seeks to reform the state’s behavioral health system and find ways to improve care for Alaskans experiencing serious mental illness, substance use disorder, and severe emotional disturbance.  

In November the substance use component portion of the waiver was approved, but the rest is still under review by CMS.

This approval allows the division to move forward with addressing gaps in services for substance use disorder by providing Medicaid coverage for upstream prevention efforts in the areas of improved screening, referral, treatment and recovery support…While many treatment options for substance use disorder are currently covered by Medicaid, the waiver aims to increase the continuum of treatment choices for substance use disorder, as well as bolster the capacity of providers to offer those services,” reads the update.

In an email, Gennifer Moreau, Director of DHSS’s Division of Behavioral Health, stated that the remainder of the waiver is still being negotiated, but it is nearing approval.

The DHSS update points to several newly-approved treatment services that will now be covered by Medicaid to assist Alaskan’s experiencing SUD. The services covered by Medicaid include:

  • Intensive Outpatient Program (IOP): services focused on addressing lifestyle, behavioral, and attitudinal issues that “impair the person’s ability to cope with major life tasks without use of substances”
  • Partial Hospitalization Program (PHP): 20 or more hours per week of “clinically intensive outpatient programming” that focus on issues addressed in IOP, but also can treat individuals with substantial medical and psychiatric problems
  • Withdrawal management: includes supervision and support services in a variety of settings
  • Residential: observation, monitoring, and treatment services available in an in-patient living environment
  • Community Recovery Support Services: counseling and wraparound services for newly-recovered individuals