Section 1115 Demonstrations: Substance Use Disorders, Serious Mental Illness, and Serious Emotional Disturbance

As part of the U.S. Department of Health and Human Services’ effort to combat the ongoing opioid crisis, the Centers for Medicare & Medicaid Services (CMS) created an opportunity under the authority of section 1115(a) of the Social Security Act (Act) for states to demonstrate and test flexibilities to improve the continuum of care for beneficiaries with substance use disorders (SUDs) including Opioid Use Disorder. In addition, CMS created similar flexibility to test more comprehensive approaches to care for beneficiaries with serious mental illness (SMI) or serious emotional disturbance (SED). The states listed on this page have section 1115(a) demonstration programs approved in accordance with these new opportunities to address particular challenges raised by the opioid epidemic in their state.

CMS also developed tools and guidance to support state approaches to monitoring and evaluation of their 1115 initiatives to combat the opioid crisis, SUD more generally, as well as SMI and SED. These materials align with CMS’ requirements for these section 1115 demonstrations. To learn more about these tools and guidance, please review the 1115 Demonstration State Monitoring & Evaluation Resources webpage.

Approved States
State Demonstration Title
Alaska Alaska Substance Use Disorder and Behavioral Health Program (SUD-BHP)
California California Medi-Cal 2020
Delaware Delaware Diamond State Health Plan
District of Columbia D.C. Behavioral Health Transformation
Illinois Illinois Behavioral Health Transformation
Indiana Healthy Indiana Plan
Kansas KanCare
Kentucky KY HEALTH
Louisiana Healthy Louisiana OUD/SUD Demonstration
Maryland Maryland Maryland Health Choice
Massachusetts MassHealth
Michigan Michigan 1115 Behavioral Health Demonstration
Minnesota Minnesota Substance Use Disorder System Reform
Nebraska Nebraska Substance Use Disorder Section 1115 Demonstration
New Hampshire New Hampshire SUD Treatment and Recovery Access
New Jersey New Jersey FamilyCare Comprehensive Demonstration
New Mexico New Mexico Centennial Care 2.0 1115 Medicaid Demonstration
North Carolina North Carolina’s Medicaid Reform Demonstration
Ohio Ohio Section 1115 Demonstration Waiver for Substance Use Disorder Treatment
Pennsylvania Pennsylvania Medicaid Coverage Former Foster Care Youth From a Different State & SUD Demonstration
Rhode Island Rhode Island Comprehensive Demonstration
Utah Utah Primary Care Network
Vermont Vermont Global Commitment to Health
Virginia The Virginia GAP and ARTS Delivery System Transformation
Washington Washington Medicaid Transformation Project
West Virginia West Virginia Creating a Continuum of Care for Medicaid Enrollees with Substance Use Disorders
Wisconsin Wisconsin BadgerCare Reform