Ensuring a Full Continuum of SUD Benefits

In accordance with House Bill 18-1136, the Department of Health Care Policy and Financing (Department) will be working to provide the full continuum of Substance Use Disorder (SUD) benefits to Health First Colorado (Colorado’s Medicaid program) members. The Department will be adding the inpatient and residential components, including withdrawal management, to the continuum of outpatient SUD services currently available. The Department’s objective is to make these services available for individuals who meet nationally-recognized evidence-based level of care criteria without shifting care from outpatient settings when they are more appropriate.

May 2020 Update

SUD Implementation Plan update

Program staff continue to collaborate with the Centers for Medicaid and Medicare Services (CMS) on the SUD waiver Implementation Plan. The Department submitted the draft Implementation Plan per CMS requirements and is currently awaiting additional guidance on the document from CMS. Program staff are also focusing efforts on creating and developing other waiver application components, such as the Health IT Plan and Monitoring Protocol.

Capacity Assessment and Expansion Plan

The Department and Capacity Expansion Plan Work Group is concluding its analysis of SUD treatment provider capacity across the state.  In addition, plans for expanding capacity where needed are in development. This plan will highlight how available resources can be utilized to support and incentivize expansion where needed.  While expansion of the provider network will be necessary to meet the expected demand for SUD services, the workgroup acknowledges that the current COVID-19 crisis presents a number of challenges to that process.  The Department continues to assess the changing landscape for treatment providers.

Coming soon: MAT information for treatment providers, partners and stakeholders

Medicaid coverage for residential and inpatient services requires that providers facilitate access to MAT for its patients.  In order to support providers in arranging for access, the Department’s program staff are developing a Medication Assisted Treatment (MAT) Toolkit.  Stay tuned to future SUD Updates for this information.


Information for Providers

Now available: Frequently Asked Questions about new SUD benefit expansion

A list of frequently asked questions (FAQ) regarding the Department’s SUD benefit expansion is now available.

Update on ASAM training for providers

In previous Substance Use Disorder (SUD) Updates, treatment providers were encouraged to acquaint, or reacquaint, their staff with the American Society of Addiction Medicine (ASAM) criteria, which will be utilized as the basis for the management of SUD benefits covered by Health First Colorado. As of this month, 260 individuals registered for the ASAM training. About one-half of registrants have completed the first training component.  Components #2 and 3 will be offered in June. The Colorado Department of Health Care Policy & Financing gratefully acknowledges the cooperation and assistance from the Colorado Office of Behavioral Health and Signal Behavioral Health Network in making this free, one-time ASAM training available to providers.