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While Medicaid is a key policy lever to improve access to substance use disorder treatment, many state Medicaid programs do not cover the full continuum of substance use disorder treatment and impose utilization management parameters-for example, prior authorization and medication quantity limits-that may restrict access to care. Moreover, most states contract with managed care organizations (MCOs). While the nation's 281 Medicaid MCO plans cover over 70% of all enrollees, little is known about how they cover substance use disorder treatment. In this course, we will present findings of our research examining Medicaid managed care coverage for substance use disorder treatment and describe what is known regarding the effects of Medicaid MCO restrictions on SUD treatment coverage.

At the end of the seminar learners will be able to:

• Understand how Medicaid coverage and utilization managements policies work, with a specific focus on substance use disorder treatment.
• Identify trends in Medicaid coverage and utilization management policies across different types of treatment services and medications for substance use disorder.
• Describe what is known about the effects of Medicaid coverage restrictions on patient access to substance use disorder treatment.

Dr. Christina Andrews' research interests include the organization and financing of substance use disorder treatment on service access, with a particular focus on strategies to address the opioid epidemic. She is currently Co-Principal Investigator on two multi-year research grants funded by the National Institutes of Health assessing the effects of Medicaid managed care on access to alcohol use disorder treatment and opioid use disorder treatment. Dr. Andrews is also a Co-Investigator on three additional NIDA-funded projects: a survey of Medicaid coverage for opioid use disorder treatment, and a study of financing for opioid use disorder treatment within the criminal justice system as part of NIDA's Justice Community Opioid Innovation Network (JCOIN) initiative. Her work has been published in scientific journals, such as the New England Journal of Medicine, Health Affairs and the American Journal of Public Health. In 2016, she received the Breakthrough Star Award, presented annually to early-career faculty for research excellence by the USC Office of the Vice President for Research. Professor Andrews research training was supported through multi-year predoctoral training fellowships from the Agency for Healthcare Quality and Research and the National Institute on Drug Abuse. She received her a Doctor of Philosophy from the University of Chicago.

Dr. Amanda J. Abraham is an Associate Professor of Public Administration and Policy in the School of Public and International Affairs at the University of Georgia. Her research focuses on the impact of federal and state policy on the accessibility and quality of substance use disorder (SUD) treatment, with a focus on the Medicaid and Medicare populations. Dr. Abraham currently serves as principal investigator and co-investigator on numerous federal grants funded by the National Institute on Alcohol Abuse and Alcoholism, National Institute on Drug Abuse, and National Center for Advancing Translational Science.

Funding for this initiative was made possible (in part) by grant no. 1H79TI085588 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Financial Disclosure & Disclaimer: This program receives no commercial financial support.

The information in this educational activity is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition. The viewpoints expressed in this CME activity are those of the authors/faculty. They do not represent an endorsement by the AOA. In no event will the AOA be liable for any decision made or action taken in reliance upon the information provided through this CME.