Media
Substance Use Disorder and Serious Mental Illness Waiver header image

Approval to implement the Missouri Substance Use Disorder and Serious Mental Illness 1115(a) Demonstration Waiver was received on December 6, 2023. Through this demonstration, the state will expand access to a full continuum of services across American Society of Addiction (ASAM) levels of care statewide for opioid use disorder (OUD) and other substance use disorders (SUD), as well as support access to a full continuum of mental health treatment services, by allowing Medicaid coverage and reimbursement for inpatient psychiatric services provided to eligible adults with SUD ages 12-64 within an IMD. Approval of the SUD program will allow the state to add Medicaid reimbursement for residential SUD services for individuals who meet medical necessity criteria, including residential SUD services in facilities that qualify as an institution for mental disease (IMD). In addition, approval of the serious mental illness (SMI) program will allow the state to add reimbursement for acute inpatient stays in an IMD.

 Public Notice

2024

04.29.2024 - SUD & SMI 1115 Demonstration Waiver Post-Award Forum Public Notice

2022

06.10.2022 - Public Notice regarding the 1115 waiver demonstration application seeking authority to reimburse for medically necessary residential substance use disorder (SUD) services furnished in facilities that qualify as an institution for mental disease (IMD)
06.10.2022 - Public Notice regarding the 1115 waiver demonstration application seeking authority to reimburse for medically necessary residential substance use disorder (SUD) services furnished in facilities that qualify as an institution for mental disease (IMD)
06.22.2022 - Public Notice regarding reimbursement for acute inpatient stays institutions for mental disease (IMD) for Medicaid enrollees ages 21-64 diagnosed with a serious mental illness (SMI).

 Waiver Documents

 Provider Manual

 Education & Training

 Forms

 Resources

MO HealthNet News

The table below provides general information and updates that are relevant to this program page, as well as all MO HealthNet providers. To find information for all other MO HealthNet programs, or to search by date, program or keyword, visit the MO HealthNet News page. If you would like to receive updates in your inbox, subscribe to MO HealthNet News!
Date Volume Number Subject Type Program
09/24/2018 Updated EBPT Invoice Hot Tips All MO HealthNet Providers
07/16/2018 41-06 Primary Care Health Home Bulletins All MO HealthNet Providers
05/11/2018 Participants with Other Insurance Coverage Hot Tips All MO HealthNet Providers
02/02/2018 40-47 Telehealth Bulletins All MO HealthNet Providers
01/30/2018 40-45 2018 Healthcare Common Procedure Coding System Bulletins All MO HealthNet Providers
10/26/2017 40-27 Ordering Prescribing and Referring Provider Requirements Bulletins All MO HealthNet Providers
10/05/2017 Reimbursement Issues – Pricing Inquiry Process Hot Tips All MO HealthNet Providers
10/05/2017 Immunizations for Dual Eligible Participants Hot Tips All MO HealthNet Providers
10/04/2017 40-25 ICD-10 Annual Updates 2017 Bulletins All MO HealthNet Providers
08/15/2017 40-18 Providers Billing Pharmacy Claims Bulletins All MO HealthNet Providers
08/10/2017 40-17 Providers Billing Pharmacy Claims Bulletins All MO HealthNet Providers
08/01/2017 40-16 Medicaid Management Information System MMIS Data Center and Computer Hardware Replacement Bulletins All MO HealthNet Providers
04/28/2017 Aetna Inpatient Care Hot Tips All MO HealthNet Providers
04/28/2017 Managed Care Goes Statewide on May 1, 2017 Hot Tips All MO HealthNet Providers
04/24/2017 Verifying Participant Eligibility Hot Tips All MO HealthNet Providers