In 2015, West Virginia experienced the highest rate of deaths due to opioid overdoses in the United States, resulting in 41.5 deaths per 100,000 people, and a remarkable one-year increase in opioid deaths of 15%. The opioid crisis in West Virginia has garnered a lot of attention, including concerted efforts by the State and federal governments to increase the availability of treatment options to stem the crisis, especially for the Medicaid eligible population.

These efforts have now borne fruit. On October 10, 2017, Cindy Beane, Commissioner of the West Virginia Bureau for Medical Services (BMS), announced that the Centers for Medicare and Medicaid Services (CMS) approved a West Virginia Medicaid Waiver under Section 1115 (a) of the Social Security Act to expand certain treatments for Medicaid beneficiaries with Substance Use Disorders (SUDs) in West Virginia, including:

  1. Programs to reimburse Naloxone treatments, including first responders and other providers.
  2. Programs to reimburse Methadone treatment services.
  3. Programs to provide new short-term 30-day residential treatment services.

Prior to this development, the services available to the Medicaid population in West Virginia were limited, and resources were stretched too thin. The new Section 1115 (a) Waiver is to be effective as of January 1, 2018, and is expected to significantly improve the ability of the West Virginia Medicaid program to address the opioid crisis with more effective treatment programs. The Section 1115 (a) Waiver was approved by Seema Verma in a letter dated October 6, 2017, establishing the parameters for the five-year demonstration project in West Virginia.