Medicaid waiver (1115) will improve behavioral health services for Alaskans

Under the direction of the Walker Administration, the Department of Health and Social Services has been working diligently for the past two years on a waiver to federal Medicaid rules known as the 1115 Behavioral Health Waiver. This waiver would expand and make more available treatment services for Alaskans struggling with addiction, would help address Alaska’s opioid epidemic and improve health outcomes for Alaskans.

DHSS received word on Nov. 21 that the Centers for Medicare and Medicaid Services (CMS) had approved the portion of the waiver that applies to substance use disorder services.  To learn more, read the Governor’s Office press release.

This waiver gives our state permission to implement new approaches that provide Alaskans with comprehensive, cost-effective, high-quality behavioral health services designed to ensure access to the right services at the right time in the right setting. In other words, people who need treatment for substance use disorder will be able to get access sooner, closer to home.

The process for these waivers is lengthy. The Department submitted the initial paperwork for the waiver in fall 2017 and submitted the waiver application in January 2018. Since then, DHSS has been negotiating with the Center for Medicaid Services (CMS) over details of the waiver and how it would be implemented.  The 1115 waiver will allow DHSS to provide treatment services it would not otherwise be able to cover. Examples of these new services include:

  • Community-based services: Under the 1115 waiver, more outpatient treatment options will be available throughout Alaska. This will alleviate the problem of patients moving into residential care when they might be better suited for outpatient care.
  • Medication assisted treatment care coordination: MAT care coordination is a new service that will connect primary health care with behavioral health treatment, legal and social services, and other necessary components to improve long-term outcomes for patients struggling with addiction.
  • Early screening and intervention: New screening and intervention services will be implemented in Alaska emergency departments to identify people with early signs of addiction. Providers will be able to intervene sooner and prevent the future need for more intense treatment services.
  • More treatment beds: Currently, residential treatment facilities with more than 16 beds cannot bill Medicaid. CMS has waived this rule for Alaska, making approximately 66 additional treatment beds available to Alaska Medicaid recipients.

Substance use disorder services is only one component of Alaska’s 1115 Behavioral Health Waiver Demonstration Project. DHSS will continue to work with CMS to seek approval for the remainder of its 1115 Waiver application. If approved, the waiver would provide much-needed community-based and early intervention behavioral health services throughout Alaska.


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