West Virginia Substance Use Disorder Demonstration Waiver

​This page is intended to provide information to the local, state and federal Medicaid community regarding the West Virginia Substance Use Disorder demonstration waiver. ​

The West Virginia Department of Health and Human Resources (DHHR) recognizes that our State is facing a public health crisis as a result of the prevalence of substance use disorder (SUD) issues.  On November 30, 2016, Governor Earl Ray Tomblin announced the West Virginia DHHR, Bureau for Medical Services (BMS) submitted a 1115 Substance Use Disorder (SUD)  demonstration waiver for approval to the U.S. Centers for Medicare and Medicaid Services (CMS).  Below is the West Virginia SUD Completeness Letter from CMS.

West Virginia SUD Completeness Letter

The goals of the SUD demonstration waiver are to improve quality of care and population health outcomes for Medicaid enrollees with SUD issues; increase enrollee access to, and utilization of, appropriate SUD treatment services based on Amercian Society of Addiction Medicine (ASAM) criteria; decrease utilization of high-cost emergency department and hospital services by enrollees with a SUD; and improve care coordination and care transition for Medicaid enrollees with SUD issues.

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