ASAM Criteria Key Component of New CMS Waiver

The Centers for Medicare & Medicaid Services (CMS) announced a new policy to allow states to design demonstration projects that increase access to addiction treatment. Under the policy update, states will be required to design their system delivery to be in alignment with The ASAM Criteria or other validated addiction treatment criteria.

This new policy updates a previous CMS demonstration waiver released in 2015 (see California to Revamp Addiction Treatment for Medicaid Recipients).  The update is designed to increase flexibility and open the 2015 program up to a larger audience, thereby improving the access of Medicaid beneficiaries to quality addiction treatment.

“This new demonstration policy comes as a direct result of the President’s commitment to address the opioid crisis and ensure states have immediate relief and flexibility,” said CMS Administrator Seema Verma. Read the press release, CMS announces new Medicaid policy to combat the opioid crisis by increasing access to treatment.

The newly issued section 1115(a) demonstration waiver states specifically that applicants must “demonstrate how they are implementing-evidence-based treatment guidelines, such as those published by the American Society of Addiction Medicine (ASAM).” ASAM has been supporting states in meeting these requirements through the use of its ASAM CONTINUUM® product line and a forthcoming ASAM Level of Care Certification program. Both the ASAM CONTINUUM assessment product line and the certification allow states to ensure that Medicaid beneficiaries have access to the highest quality and most cost efficient delivery of care. To talk to an ASAM representative about ASAM CONTINUUM or the ASAM Level of Care Certification, please fill out the ASAM contact form.

The full CMS section 1115(a) demonstration waiver may be read online on the CMS website.