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Substance Use Disorder Treatment and Recovery Access Section 1115(a) Research and Demonstration Waiver

August 3, 2018

The Centers for Medicare & Medicaid Services (CMS) is issuing Technical Corrections Adobe Acrobat Reader Symbol to the NH Section 1115(a) Medicaid demonstration, titled "Substance Use Disorder Treatment and Recovery Access" (SUD-TRA) (Project Number 11-W-00321/1), which was approved on July 10, 2018, under the authority of section 1115(a) of the Social Security Act. The technical corrections ensure that the Special Terms and Conditions reflect how the State is currently operating its demonstration.

The State of New Hampshire Department of Health and Human Services (DHHS), as the single-state Medicaid agency, is seeking 1115(a) Demonstration Waiver authority to support Medicaid payments for individuals receiving Substance Use Disorder (SUD) services in an Institution for Mental Disease (IMD).

SUD IMD Waiver Federal Comment Period – Updated June 14, 2018
As part of New Hampshire’s statewide effort to combat the ongoing opioid crisis, and in response to the nation’s recently-extended public health emergency, the NH Department of Health & Human Services submitted an application for the “New Hampshire Substance Use Disorder Treatment and Recovery Access” Section 1115(a) Research Demonstration. The goal of the demonstration is to improve access to, and quality of, residential substance use disorder (SUD) treatment for Medicaid beneficiaries in our State. Due to the declared public health emergency, comments on the budget neutrality may be submitted concurrently with the federal comment period which is open April 26, 2018 through May 26, 2018. Please see the Department and CMS letters below as well as the link to the federal comment process.

Public Comment and Responses from NH DHHS Federal Comment Period April 26, 2018 – May 26, 2018 Adobe Acrobat Reader Symbol

Letters of Comment April 26, 2018 to May 26, 2018

SUD IMD Waiver Submitted to CMS

As part of statewide effort to combat the ongoing opioid crisis, the State of New Hampshire’s application for a Section 1115(a) Demonstration Waiver, the “New Hampshire Substance Use Disorder Treatment and Recovery Access Section 1115(a) Research and Demonstration Waiver,” to improve access to and quality of residential substance use disorder (SUD) treatment for Medicaid beneficiaries, has been submitted. Please see the application for a Section 1115(a) Demonstration Waiver and Waiver Application Cover Letter below.

February 27, 2018 Notice
Notice is hereby given that the DHHS is seeking public input on a Substance Use Disorder Treatment and Recovery Access Section 1115(a) Research and Demonstration Waiver Adobe Acrobat Reader Symbolthat will enable New Hampshire to provide Medicaid payments for individuals receiving SUD services in an IMD.

Specifically, New Hampshire is requesting:

  • The Center for Medicare and Medicaid Services (CMS) waive Section 1905(a)(29)(B), 42 CFR 438.6(e), and 42 CFR 435.1010 to allow a waiver of the IMD exclusion for Medicaid-eligible individuals ages 21-64 receiving residential SUD treatment in an IMD as long as is medically necessary.
  • CMS expand the exception to the IMD exclusion in 42 CFR 441.11(c)(5) to the provider type, Comprehensive SUD Program, as described in He-W 513.02(b), to allow New Hampshire to claim federal financial participation (FFP) for individuals under 21 receiving residential substance use disorder treatment in these facilities for as long as is medically necessary.

Expenditure authority is being requested for individuals who meet the criteria above who are either covered as Medicaid fee-for-service or enrolled in Medicaid managed care.

The Demonstration will further the objectives of Title XIX of the Social Security Act by increasing access to, stabilizing, and strengthening providers and provider networks, available to serve Medicaid and low-income populations in the state. This will be accomplished by ensuring continuity of care for individuals receiving SUD treatment, increasing access to residential treatment services for adolescents with SUD, and ensuring consistency between public and private coverage for SUD services in New Hampshire.

30-Day Public Comment Period and Waiver
The 30-day public comment period for the Substance Use Disorder Treatment and Recovery Access Section 1115(a) Research and Demonstration Waiver Adobe Acrobat Reader Symbol is from Tuesday, February 27, 2018 until Friday, March 30, 2018 at 12 Noon (Eastern). All comments must be received by 12 Noon (Eastern) on Friday, March 30, 2018.

Written comments may be submitted to imdsudwaiver@dhhs.nh.gov.

Public Hearings
DHHS will host two public hearings during the public comment period.

  • Tuesday, March 6, 2018 – Manchester
    6:00 - 7:30 pm

    Manchester Health Department
    1528 Elm Street Manchester, NH
    Call-in option: To participate by phone, call in at 6:00 pm to: 1-866-470-8024
    When prompted, use this code: 965 412 0884
    Snow Date: Thursday, March 8, 2018, 6 - 7:30 pm, Manchester Health Department

  • Tuesday, March 13, 2018 - Nashua
    POSTPONED TO MARCH 14 (same time and location)
    1:00 - 2:30 pm

    Harbor Homes - Partnership for Successful Living
    77 Northeastern Blvd, Nashua, NH
    Snow Date: Wednesday, March 14, 2018, 1-2:30 pm, Harbor Homes Partnership for Successful Living
  • View Substance Use Disorder Treatment and Recovery Access Section 1115(a) Research and Demonstration” public hearing presentation Adobe Acrobat Reader Symbol

    If accommodations are needed for communication access such as interpreters, CART (captioning), assistive listening devices, or other auxiliary aids and/or services, please contact Leslie Melby at Leslie.Melby@dhhs.nh.gov or 603-271-9074, no later than March 1, 2018. Every effort will be made to accommodate needs identified with advance notice.

    Comments will also be considered at the Monday, March 12, 2018 Medical Care Advisory Committee Meeting, from 10-12 p.m. All Medical Care Advisory Committee Meetings are open to the public.

    Medical Care Advisory Committee Meeting location:
    NH Hospital Association
    125 Airport Rd, Conference Room 1
    Concord NH 03301

Ways to Submit Comments
DHHS would like to hear your comments about the changes it is proposing. After hearing the public’s ideas and comments about the proposed changes, DHHS will make final decisions about what changes to make to the Substance Use Disorder Treatment and Recovery Access Section 1115(a) Research and Demonstration Waiver and then submit to CMS. The summary of comments will be posted for public viewing on this page, along with the waiver application when it is submitted to CMS.

There are several ways to submit your comments to DHHS:

  • Attend either of the two public hearings to be held at the dates/locations noted above. At the public hearings, you may give verbal or written comments to DHHS;
  • Email comments to imdsudwaiver@dhhs.nh.gov; or
  • Mail written comments to:
    Ms. Leslie Melby
    New Hampshire Department of Health and Human Services
    Attn: Substance Use Disorder Treatment and Recovery Access Section 1115(a) Research and Demonstration Waiver
    129 Pleasant Street
    Concord, NH 03301

When mailing or emailing please specify the Substance Use Disorder Treatment and Recovery Access Section 1115(a) Research and Demonstration Waiver.

Additional Information
Requests for a hard copy of the Waiver application should be submitted by mail to:

Ms. Leslie Melby
New Hampshire Department of Health and Human Services
Attn: Substance Use Disorder Treatment and Recovery Access Section 1115(a) Research and Demonstration Waiver
129 Pleasant Street
Concord, NH 03301

A hard copy of the Substance Use Disorder Treatment and Recovery Access Section 1115(a) Research and Demonstration Waiver can also be picked up at DHHS, which is located at:

New Hampshire Department of Health and Human Services
Fred H. Brown Building
129 Pleasant Street
Concord, NH 03301

Adobe Acrobat Reader Symbol Adobe Acrobat Reader format. You can download a free reader from Adobe.

 
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New Hampshire Department of Health and Human Services
129 Pleasant Street | Concord, NH | 03301-3852


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