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) (PDF, 170.7 KB) 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) (PDF, 387.24 KB) . 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.