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DHS seeks input on Medicaid coverage of residential treatment for substance use disorder

January 30, 2020 1:37 PM | Anonymous

Wisconsin Health News

The Department of Health Services is planning to re-work a benefit for residential treatment for substance use disorder that was set to start Feb. 1. The agency delayed implementation last Friday.

Curtis Cunningham, assistant administrator for long-term care benefits and programs at the Division of Medicaid Services, said during a Wednesday webinar they consider the review a “fresh restart” on the policy. 

“This is the start of a conversation, not an end,” Cunningham said.

There’s no new timeline on implementing the benefit, but they’re hoping to start a work group in the next 30 days to weigh in, he said.

Pam Appleby, director of the Bureau of Benefits Management at the Division of Medicaid Services, said they heard concerns about the benefit, including requests that the agency ensure rates cover costs, provide reimbursement timely and have a fast, streamlined authorization process.

“We understand that delays can cause a member to walk away and never come back,” Appleby said.

Other concerns were about housing for members, discharge requirements for patients who don't have homes and how the benefit would work with those in the corrections system.

The agency also heard that some providers who offer specialized services that go beyond the basic benefit requirements need a reimbursement system that would cover their cost.

They’ve also heard feedback from counties support the benefit and its impact. And they’ve also had conversations about funding for room and board and how to keep local governments involved in the treatment, Appleby said.

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