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Kentucky has announced that substance use disorder services for people on Medicaid will be enhanced under a portion of the state’s Section 1115 Medicaid waiver that wasn’t vacated by a judge’s ruling this summer.

Much of the attention on the waiver has focused on the work or “community engagement” requirement, which is part of the waiver that was sent back to the federal government for further review in June and remains in limbo.

But the Cabinet for Health and Family Services says the federal government has approved the state’s implementation plan for substance use disorder (SUD) services. This is expected to help the state tackle its drug problem by, among other things, providing for coverage of methadone, a type of medication-assisted treatment.

“Expanding access to treatment and recovery services for individuals with substance use disorder is critical to our efforts to combat the opioid epidemic in Kentucky,” Cabinet Secretary Adam Meier said in a news release Monday. “We have worked diligently to identify areas within the Medicaid program where care and treatment options can be expanded and improved. This demonstration waiver gives us the opportunity to help more Kentuckians get treatment and start on the path to recovery.”

As reported previously by Insider Louisville, fatal drug overdoses in Kentucky increased by 11.5 percent, to 1,565 in 2017, with the powerful opioid fentanyl being present in most cases, according to the annual fatality report from the Kentucky Office of Drug Control Policy.

The report showed that Jefferson County once again led the state by a wide margin with 426 fatal drug overdoses last year — a 17 percent increase from 2016 — with fentanyl being involved in 64 percent of these deaths, Insider noted.

With the federal approval, the state will be able to help more Kentuckians who need assistance to beat their drug problems, according to the state.

Medicaid will be able to reimburse for short-term residential stays of up to 30 days in mental health facilities, and the state will work to expand its network of providers that meet certain standards of care, according to the release.

“Under the implementation plan, providers can attest to the level of care provided at treatment facilities, which will be verified through subsequent certification visits,” the news release notes.  “This process will ensure more bed capacity for residential treatment facilities (the current policy limits coverage to 16 beds), while also elevating program standards regarding the types of services, hours of clinical care, and credentials of staff in such settings.”

Kentucky Voices for Health, which advocates on behalf of consumers, issued a statement, on the SUD services announcement.

“Kentucky Voices for Health and our partners applaud any efforts to combat the substance use disorder epidemic gripping our Commonwealth,” Executive Director Emily Beauregard said in the statement.  “Today’s announcement that CMS has approved Kentucky’s request to expand and improve upon substance use services demonstrates that we can leverage our Medicaid program to be innovative and responsive to the needs of our Commonwealth without the harmful barriers the rest of the 1115 waiver would place in the way of Kentuckians struggling with addiction and other basic needs.”

Darla Carter is a hometown girl who recently joined the staff of Insider Louisville to mostly cover health. She previously served as a longtime health and fitness writer for The Courier-Journal, where she also worked for the Metro, Neighborhoods and Features departments. Prior to that, the award-winning journalist wrote for newspapers elsewhere in Kentucky and Tennessee, covering a range of topics, from education to courts. She's a graduate of Western Kentucky University, where she studied journalism and philosophy, and is the proud mom of two young children.


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