Public Notice of Final Action for the Coverage of Opioid Treatment Program (OTP) Services

The South Carolina Department of Health and Human Services (SCDHHS) gives notice of the following action regarding the coverage of opioid treatment program (OTP) services under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Between 2014 and 2016, there were approximately 1,645 opioid related deaths in South Carolina. As part of SCDHHS' efforts to combat the opioid epidemic in South Carolina and reduce mortality rates associated with overdose, SCDHHS is seeking to expand coverage of medication-assisted treatments (MAT).

Effective on or after Jan. 1, 2019, SCDHHS will amend the South Carolina Title XIX State Plan to include covered services for OTPs. These services are intended to provide medically necessary treatment to eligible Medicaid beneficiaries with a confirmed diagnosis of opioid use disorder (OUD). These services must be provided in a clinic that is approved to render methadone maintenance therapy by the Drug Enforcement Agency (DEA) and accredited by the Substance Abuse and Mental Health Services Administration (SAMHSA). OTP clinic services provided must be consistent with 42 CFR 8.12.

The SCDHHS projects that based upon the above actions, annual aggregate Medicaid expenditures will increase by approximately $6.8 million in the initial year.

Copies of this notice are available at each SCDHHS Healthy Connections Medicaid county office and at www.scdhhs.gov for public review. Additional information regarding this action is available upon request at the address cited below.

Any written comments submitted may be reviewed by the public at the SCDHHS, Division of Behavioral Health, Jefferson Square Building, 1801 Main Street, Columbia, South Carolina, Monday through Friday between the hours of 9 a.m. and 5 p.m.