California To Revamp Addiction Treatment For Medicaid Recipients

California is the first state to receive federal permission to revamp their treatment system for Medicaid recipients, reports Kaiser Health News. The overhaul of California’s “Medi-Cal” care system will offer treatment based on the continuum of care outlined in ASAM’s Criteria. Specifically, Kaiser News reports that “…the five-year pilot project was approved by the federal Centers for Medicare & Medicaid Services (CMS) in August. Under the [CMS] waiver, California counties will approve treatment for Medi-Cal patients based on medical necessity and criteria established by the American Society of Addiction Medicine.”

CONTINUUM™ is appropriate to propose by states applying under the CMS 1115 Waiver for alternative substance use disorder service delivery to meet the requirement that each patient’s admission be independently reviewed by a third party. The CMS waiver requires that “level of care and length of stay recommendations must be performed by an independent third party that has the necessary competencies to use ASAM Patient Placement Criteria.” For any questions about how to apply ASAM’s criteria or CONTINUUM to meet the waiver requirements, please email asamcriteria@asam.org or call (301) 656-3920.