Current Suspected Overdose Deaths in Delaware for 2024: Get Help Now!

Find school water testing results and additional resources

Attention Medicaid Participants: Eligibility Renewals Restarted April 1, 2023

Delaware.gov logo

DMMA SUPPORT Act Planning Grant and Demonstration Project


In October of 2019, Delaware’s Division of Medicaid and Medical Assistance (DMMA) was one of 15 states nationally to be awarded a planning grant from the Centers for Medicare and Medicaid Services (CMS) under section 1003 of the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act. In October of 2021, DMMA was one of five states to be awarded a SUPPORT Act Demonstration Project, a 36-month initiative beginning September 30, 2021, and running through September 30, 2024. DMMA is using this funding to assess and improve the capacity of Medicaid substance use disorder (SUD) providers to serve Medicaid beneficiaries with SUD.

Provide Input into Delaware Medicaid’s Office-Based Opioid Treatment Model 

DMMA is designing an Office-Based Opioid Treatment (OBOT) model. DMMA plans to designate outpatient medical practices as OBOTs to receive enhanced reimbursement to deliver OBOT services. This initiative supports DMMA’s goal to increase adoption of life-saving buprenorphine treatment in outpatient medical settings for Medicaid beneficiaries with opioid use disorders. After a national scan of best practices, DMMA has proposed specifications for its OBOT model, delineating eligible provider types, patient eligibility criteria, service descriptions, payment model, staffing requirements, performance measures, and other details located in DMMA’s Concept PaperDMMA now wishes to engage stakeholders to refine the model. 
 
To provide your input, please respond to one or both surveys below: 
 
OBOT Provider Survey. This survey is designed to solicit feedback specifically from provider organizations that would potentially serve as OBOTs in Delaware. Estimated completion time for this survey is 15 minutes. Providers are also encouraged to complete the more extensive Collaborating Entity Survey below. 
 
Collaborating Entity Survey. This survey is for various entities – including managed care organizations, state agencies, professional associations, health systems, and others – who are vital in the design and implementation of DMMA’s OBOT model, whether or not they plan to directly deliver OBOT services. Estimated completion time for this survey is 45 minutes. 
 
Survey responses are due by 3/29/24. If you prefer to send a written response or have questions, please contact SUPPORT@delaware.gov.

SUD Prevalence Study

With funding from the SUPPORT Act Planning Grant, DMMA contracted with the University of Delaware Center for Community Research and Service to produce the Annual Prevalence Report (2014-2019) for Substance Use Disorder Among Medicaid Clients. The report includes statewide SUD and opioid use disorder (OUD) prevalence rates among Delaware Medicaid beneficiaries, as well as other key indicators such as demographics and subpopulations impacted by SUD/OUD, rates of co-occurring mental illness and polysubstance use, and county- and zip code-level OUD prevalence rates. To view the report, click here.

Medicaid SUD Rate Study

In December 2020, DMMA contracted with Health Management Associates to release a structured survey to Delaware SUD providers to collect information on the costs associated with delivering SUD services. Data from returned surveys, qualitative feedback from providers, and data from other external sources (e.g., Bureau of Labor Statistics’ data) were used to inform draft rate models. Draft rate models were presented to SUD providers on January 26, 2022; find webinar recording here and slides here. On April 20, 2022, additional details were presented about SUD rate model construction and assumptions; find the webinar recording here, the slides here, and the updated draft rate models here. DMMA released draft SUD rates for public comment in September 2022.

Effective January 1, 2023, Medicaid SUD payment rates were updated as detailed in the table below. DMMA instituted these payment rate changes within the Medicaid fee-for-service (FFS) program.

Please contact Jacob.Bowling@delaware.gov if you have any questions about the updated SUD payment rates.

 

 

Service Description (HCPCS code and required modifier, if applicable)

 

 

Unit

 

 

Former Rate*

 

 

Updated Rate

 

 

ASAM Level of Care**

 

ASAM Level 1

 

 

 

 

Alcohol and/or drug assessment (H0001)

One session

$77.30

$141.79

1

Alcohol and/or drug assessment, home/community (H0001-U1)

One session

$90.26

$194.75

1

Behavioral health counseling and therapy (H0004)

Per 15 minutes

$19.33

$22.10

1

Group counseling by a clinician (H0005)

Per 45 minutes

$9.66

$13.25

1

Self-help/peer services, substance abuse program (H0038)

Per 15 minutes

$14.75

$16.38

1

Self-help/peer services, substance abuse program, home/community (H0038-U1)

Per 15 minutes

$14.75

$21.88

1

Self-help/peer services, substance abuse program, home/community (H0038-HQ)

Per 15 minutes

n/a

$3.69

1

ASAM Level 2

 

 

 

 

Subacute detoxification (residential addiction program outpatient, 23-hour) (H0012)

Per diem

$334.27

$334.27

2

Intensive outpatient (treatment program that provides at least 9 hours per week of service, but less than 20) (H0015)

Per diem

$126.79

$149.68

2.1

Partial hospitalization (treatment program that provides at least 20 hours per week of service) (H0035-HF)

Per diem

$190.18

$283.89

2.5

ASAM Level 3

 

 

 

 

Clinically managed low-intensity residential treatment (H2034)

Per diem

$150.53

$219.25

3.1

Clinically managed population-focused high-intensity residential services (H2036-HI)

Per diem

$189.44

$259.95

3.3

Clinically managed high intensity residential treatment (H2036)

Per diem

$189.44

$259.95

3.5

Medically monitored intensive inpatient residential (H2036-TG)

Per diem

$291.65

$377.60

3.7

Medically monitored intensive inpatient residential, acute withdrawal management (WM) (H0011)

Per diem

$354.67

$452.43

3.7-WM

 

Notes: DMMA increased the Medicaid fee-for-service payment rate for methadone administration (H0020) from $4.00 to $12.00 effective March 1, 2022.

*The former payment rates as listed are from the “Delaware Adult Behavioral Health DHSS Service Certification and Reimbursement Manual”, November 1, 2016. Available at: https://www.dhss.delaware.gov/dhss/dsamh/files/ReimbursementManual.pdf.

**Indicates how a given service aligns with American Society of Addiction Medicine (ASAM) levels of care as outlined in the third edition of “The ASAM Criteria: Treatment Criteria for Addictive Substance-Related and Co-Occurring Conditions.”

Office-Based Opioid Treatment Resources

As part of DMMA's efforts to expand access to Office-Based Opioid Treatment (OBOT) programs, in June 2021, DMMA created quick reference guides on available OBOT billing and coding options, prescriber and dispensing site regulations, and medication coverage options. Formal DMMA policy documents supersede any information in these guides. In July 2022, DMMA also developed a summary of clinical guidance on incorporating opioid use disorder treatment for pregnant and postpartum people into standard medical care. 

SUPPORT Act Provider Survey

A Survey to Assess Provider Capacity for Substance Use Disorder Treatment and Recovery Services
 
NORC at the University of Chicago is conducting a survey, in partnership with IBM Consulting and on behalf of the Centers for Medicare & Medicaid Services (CMS), to assess how state efforts have helped increase the capacity of providers to deliver substance use disorder treatment, including opioid use disorder treatment and recovery services. 
 
Please participate in the survey!
 
 
Web surveys were launched in January and are closing in mid-March. Findings from this survey will help CMS, as well as its partner federal agencies, understand how SUPPORT Act-related activities are working to improve provider capacity and what further improvements could be made.
 
You may have received an email from SUPPORT-Act@norc.org or a letter and postcard sent USPS, asking for your participation on behalf of NORC, IBM and CMS. The email and letter (and postcard) contain a URL and/or QR code for the survey website and a Personal Identification Number (PIN) that you enter on the website to take the survey.  Please check your spam filter to ensure your invitation is not being rejected. All responses to the survey are strictly confidential and no individual responses will be shared with any of the sponsoring agencies. 
 
If you have any questions about the survey, or experience technical difficulties taking the survey, please e-mail us at SUPPORT-Act@norc.org. You can learn more about the SUPPORT Act Provider Survey here
 
Frequently Asked Questions
 
1. How did you receive my name and email/mailing address?
We obtained your contact information from the SAMHSA Buprenorphine Practitioner Locator, the state Medicaid agency, or from the State Opioid Treatment Authority.
 
2. What if I want to review the questionnaire before I take the survey?
You can find the questionnaire that is posted on the NORC website here.
 
3. Is it important that I participate?
Yes! Absolutely! If you were asked to participate, it is very important that your experiences are represented. Findings from this survey are critical for understanding how SUPPORT Act-related activities are working, and how they could be improved to better serve Medicaid beneficiaries across the country.
 
4. Who is sponsoring this study and what is the purpose?
CMS, SAMHSA, and AHRQ have contracted with IBM Consulting to evaluate the SUPPORT Act Section 1003 Demonstration. IBM Consulting subcontracted with NORC to conduct the provider survey and focus groups as part of the evaluation. 
 
5. Who is NORC at the University of Chicago?
NORC is a non-profit, non-partisan research institution that delivers reliable data and rigorous analysis to guide critical programmatic and policy decisions. NORC has over 75 years of experience conducting social science research and is a leader in survey research. 

  

 



+