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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
01/06/2022 COVID-19: Oral Antiviral Treatment Hot Tips All MO HealthNet Providers
12/30/2021 44-34 Covid 19 Vaccine Bulletins All MO HealthNet Providers
11/19/2021 44-29 COVID 19 Flu RSV Testing Bulletins All MO HealthNet Providers
11/10/2021 44-27 Adult Expansion Group ME Code E2 Bulletins All MO HealthNet Providers
11/09/2021 44-30 Monoclonal Antibody COVID 19 Infusion Bulletins All MO HealthNet Providers
11/01/2021 COVID-19: At-Home COVID Test Coverage Hot Tips All MO HealthNet Providers
10/14/2021 90 Day Supply Requirement Hot Tips All MO HealthNet Providers
10/07/2021 44-19 ICD 10 Annual Updates Bulletins All MO HealthNet Providers
09/29/2021 44-18 COVID 19 Vaccine Bulletins All MO HealthNet Providers
09/28/2021 RSV Prophylaxis – Update #3 Hot Tips All MO HealthNet Providers
09/21/2021 44-14 Non Emergency Medical Transportation for Vaccines Bulletins All MO HealthNet Providers
08/27/2021 RSV Prophylaxis – Update #2 Hot Tips All MO HealthNet Providers
08/02/2021 RSV Prophylaxis - Update Hot Tips All MO HealthNet Providers
07/07/2021 RSV Prophylaxis Hot Tips All MO HealthNet Providers
04/12/2021 43-24 COVID-19 Vaccine Revised Bulletins All MO HealthNet Providers