Substance Use Disorder Demonstration

 
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Medicaid & Long-Term Care
 
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No

What would you like to do?

What you need to know

​​​​​​MLTC's Substance Use Disorder (SUD) demonstration waiver allows Nebraska Medicaid to cover SUD residential services in Institutions for Mental Diseases (IMDs) for Medicaid-enrolled adults ages 21-64. Coverage of residential services allows Medicaid enrollees to receive the appropriate level of care, reducing emergency department visits and increasing referrals for outpatient community-based services upon discharge. This demonstration waiver began on July 1, 2019.

Under the waiver, Nebraska has also increased access to community-based services. In June 2021, the State began ​coverage for Opioid Treatment Program (OTP) to provide Nebraskans additional outpatient treatment options. ​

The Centers for Medicare and Medicaid Services (CMS) approved Nebraska's application for a section 1115 SUD demonstration waiver. MLTC has begun the process of implementing this new waiver authority. The full text of Nebraska's 1115 SUD demonstration agreement with CMS can be found at the following link: Nebraska Section 1115 Substanc​e Use Disorder Program


Program Update 

Under the Section 1115 SUD Demonstration Waiver, the State has been able to cover 2,582 stays in Institutions for Mental Diseases (IMDs) that would not have been otherwise covered.

​​IMD Stays (July 1, 2019 - December 31, 2022)
​Total Stay Claims
4,054
Stays Under 15 Days​
1,313
Stays Over 15 Days​*
2,582
​Ongoing Stays**

159
​*Stays over 15 days account for 64 percent of IMD stays​. These stays would be otherwise not covered without the 1115 SUD waiver.
**Ongoing Stays include the number of stays still in progress at the end of the reporting period.


​Line chart showing the number of claims for SUD services increasing each calendar quarter


Program Information

Monitoring Protocol 

Waiver Materials



​Provider Education


​​Substance Use Disorder Demonstration Public Forum

​​​​Opioid Treatment Program

​​Medically Monitored Inpatient Withdrawal Management
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