PUBLIC NOTICE: Public Comment Period for State Plan Amendment (SPA) IA-21-006: Medication-Assisted Treatment (MAT)

Pursuant to the requirements outlined in 42 CFR 447.205 and 1902(a)(13)(A) of the Social Security Act, notice is hereby given that the Iowa Department of Human Services (DHS) has posted for public comment SPA IA-21-006.

This SPA is being submitted in accordance with Centers for Medicare and Medicaid Services (CMS) requirements, and is intended to clarify coverage of Medication-Assisted Treatment (MAT) and demonstrate compliance with section 1006(b) of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act.

The purpose of the proposed amendment is to clearly define that coverage of MAT for all Medicaid beneficiaries who meet the medical necessity criteria includes coverage of Naltrexone, Buprenorphine, and Methadone and all of the forms of these drugs for MAT that are approved under section 505 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355) and all biological products licensed under section 351 of the Public Health Service Act (42 U.S.C. 262). Additionally, the proposed amendment clarifies Methadone for MAT is provided by Opioid Treatment Programs that meet the requirements in 42 C.F.R. Part 8.

There is no change to the MAT service reimbursement methodology or reimbursement rates as the purpose of this proposed amendment is to clearly define coverage of the services already covered and paid for under the Medicaid program.

There is no fiscal impact related to the coverage and reimbursement proposed in the SPA as all services were covered prior to October 1, 2020.