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Public Notice of Final Action for Medication-Assisted Treatment

The South Carolina Department of Health and Human Services (SCDHHS) gives notice of the following action regarding the new Medication-Assisted Treatment (MAT) section under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Effective for dates of service on and after Oct. 1, 2020, SCDHHS will amend the South Carolina Title XIX State Plan tocreate a new MAT section. On Dec. 30, 2020, the Centers for Medicare and Medicaid Services issued guidance to states regarding section 1006(b) of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act. To increase access to MAT for opioid use disorders (OUDs), section 1006(b) of the SUPPORT Act requires states to provide Medicaid coverage of certain drugs and biological products, and related counseling services and behavioral therapy.

The new mandatory MAT benefit includes all FDA-approved drugs and licensed biologicals used for MAT to treat OUD, as well as associated counseling and behavioral therapies. Covered drugs are methadone, buprenorphine and naltrexone. Covered behavioral health services include individual/group therapy, peer support services and crisis intervention.

Currently MAT is covered under different authorities in the State Plan. To be compliant with the SUPPORT Act, SCDHHS will create a new required benefit that will be in effect for a five-year period beginning Oct. 1, 2020, and ending Sept. 30, 2025.

SCDHHS anticipates this change will be budget neutral since these services are already covered under the State Plan.

Copies of this notice are available at each SCDHHS Healthy Connections Medicaid office and at 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 Coverage and Benefit Design, Jefferson Square Building, 1801 Main Street, Columbia, South Carolina, Monday through Friday between 9 a.m.-5 p.m.

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