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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

12.23.2024 - Public Notice Regarding the Approval of the Missouri SUD and SMI 1115 Demonstration: Evaluation Design
Public Notice Regarding the Approval of the Missouri SUD and SMI 1115 Demonstration: Evaluation Design
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
03/27/2023 COVID-19: DME: Prescription Signature Hot Tips All MO HealthNet Providers
03/27/2023 COVID-19: Testing and Specimen Collection Hot Tips All MO HealthNet Providers
03/27/2023 COVID-19 Vaccines Hot Tips All MO HealthNet Providers
03/27/2023 COVID-19: 1135 Waiver for Pre-Admission Screening and Resident Review (PASRR) Hot Tips All MO HealthNet Providers
03/27/2023 COVID-19: Home Health Hot Tips All MO HealthNet Providers
03/27/2023 COVID-19: COVID-19 Testing and Specimen Collection Reimbursement Hot Tips All MO HealthNet Providers
03/27/2023 COVID-19: Registered Behavior Technician Hot Tips All MO HealthNet Providers
03/27/2023 COVID-19: Certificate of Medical Necessity Form (CMN) Signature Requirement Hot Tips All MO HealthNet Providers
03/27/2023 COVID-19: Radiology - Chest CT Scans Hot Tips All MO HealthNet Providers
03/27/2023 COVID-19: DME: Multi-Function Ventilator Hot Tips All MO HealthNet Providers
03/27/2023 COVID-19: DME: Delivery Slip Signature Requirement Hot Tips All MO HealthNet Providers
03/03/2023 Bright Futures Hot Tips All MO HealthNet Providers
03/02/2023 How to File a Claim with MHD as the Tertiary Payer Hot Tips All MO HealthNet Providers
02/27/2023 The 2022 - 2023 Respiratory Syncytial Virus (RSV) season is winding down Hot Tips All MO HealthNet Providers
02/16/2023 Participant Annual Review Date Hot Tips All MO HealthNet Providers