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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
12/15/2014 Non-Emergency Medical Transportation Hot Tips All MO HealthNet Providers
11/10/2014 Resources to Verify MO HealthNet Eligibility Hot Tips All MO HealthNet Providers
11/03/2014 Non-Covered vs. Non-Allowable Services Hot Tips All MO HealthNet Providers
10/27/2014 WebEx Meetings Conducted by Provider Education and Training Unit Hot Tips All MO HealthNet Providers
10/20/2014 Scheduled Webinars for Listed Claim Types Hot Tips All MO HealthNet Providers
10/16/2014 Participant Lock-In Hot Tips All MO HealthNet Providers
10/14/2014 Non-QMB, Medicare Part C Plan Hot Tips All MO HealthNet Providers
09/22/2014 Electronic Claim Submission Hot Tips All MO HealthNet Providers
09/15/2014 Third Party Resources Hot Tips All MO HealthNet Providers
09/02/2014 MO HealthNet Spenddown Provider Form Hot Tips All MO HealthNet Providers
07/29/2014 Bundled Value Code - Medicare UB-04 Part A Institutional Claims Hot Tips All MO HealthNet Providers
07/14/2014 Provider Participant Page Hot Tips All MO HealthNet Providers
07/08/2014 37-03 Non-Payment of State Children's Health Insurance Premium Bulletins All MO HealthNet Providers
07/07/2014 Scheduled Webinars for Listed Claims Types Hot Tips All MO HealthNet Providers
06/30/2014 Claims Processing and Payment Schedule for Fiscal Year 2015 Hot Tips All MO HealthNet Providers