CMS: Medicaid programs can fund opioid-related health IT enhancements through HITECH

Medicaid
Tim Hill, acting director of the Center for Medicaid and CHIP Services, said CMS doesn’t need to approve telehealth coverage changes for opioid treatment unless it differs from face-to-face coverage. (Getty/juststock)

Federal funding is available to state Medicaid programs to enhance the use of technology to help states manage the opioid crisis, according to new guidance from the Centers for Medicare & Medicaid Services (CMS).

Much of that funding is already available through existing legislation, the agency said. The guidance also encourages Medicaid program directors to use telehealth and telepsychiatry to coordinate care for patients with substance abuse disorder.

In a letter (PDF) to state Medicaid directors, Tim Hill, acting director of the Center for Medicaid and CHIP Services, said the CMS doesn’t need to approve telehealth coverage changes for opioid treatment unless the state elects to cover telehealth encounters differently than in-person visits.

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“States are reminded that they need not necessarily submit a state plan amendment to begin delivering covered Medicaid services through telehealth modalities,” the guidance states. “State plan amendments are only required if a state decides to reimburse for telemedicine services differently than they pay for face-to-face services, visits, and consultations.”

Although some states may choose to acquire additional federal funding through demonstration projects approved by the CMS, state Medicaid programs can “take advantage of the enhanced funding opportunities” through a 2015 rule, the Health Information Technology for Economic and Clinical Health (HITECH) Act, and the American Recovery and Reinvestment Act of 2009, Hill added. 

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Medicaid programs can also use the laws to enhance prescription drug monitoring programs, data sharing capabilities and telehealth treatment options. In some instances, as with the HITECH Act, CMS will provide 90% of the funding.

“CMS hopes states will use this information to improve the technological capacity of state Medicaid agencies, providers, and partners to address the opioid crisis and improve the health outcomes for Medicaid beneficiaries,” Hill wrote.

While the guidance does not identify new sources of federal funding, states could utilize the existing regulations to integrate PDMP data into hospital EHR or interstate health information exchange, streamlining the workflow for providers to ensure safe prescribing of opioid medications. States can claim a 90% funding match under HITECH or through the Medicaid Management Information System.

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Hill added that states can also tap into HITECH funding by integrating advanced analytics and opioid addiction screening tools into EHRs and HIEs in a way that’s consistent with Meaningful Use Stage 3.

The guidance supports the Trump administration’s five-point plan to combat the opioid crisis, which includes better data analytics, alternatives to pain management and additional research. Addiction advocates have complained that the administration’s approach offers very little additional funding to support the blueprint and that more emphasis should be placed on funding expanded treatment options.