All of Hennepin Health's product offerings cover Substance Use Disorder (SUD) services. Providers do not need to be contracted with Hennepin Health to provide care to members, but they must be enrolled with the Minnesota Department of Human Services (DHS) and willing to see Hennepin Health members.
SUD providers should complete the Provider Information Form for non-network providers to facilitate reimbursement from Hennepin Health for SUD services.
SUD reform supports the transformation of Minnesota’s SUD treatment systems from acute episodic care to a longitudinal chronic disease model. This allows for SUD diagnoses to be treated and managed like other chronic health conditions. SUD reform was passed by the Minnesota Legislature in 2017, and approved by the Centers for Medicare and Medicaid Services (CMS) in August 2018.
Up until SUD reform, the Rule 25 Chemical Health Assessment was the only means by which individuals could access SUD treatment, with the county serving as the placing authority. As part of the reform, individuals are now allowed to go directly to a provider to get a comprehensive assessment and treatment authorization. Individuals are able to select the service provider of their choice with the level of care approved.
Both the Rule 25 and comprehensive assessments will be in effect until July 2020. Hennepin Health members can access SUD assessments and treatment using either approach. As of July 2020, comprehensive assessment will be the only way individuals can access SUD services.
The following benefits are added to the Medicaid benefit set:
Withdrawal Management: Withdrawal management is defined as a clinical model of care for individuals who need to detoxify from substances that employs professional staff, and makes them available to engage, direct and refer patients to the level of ongoing care necessary for recovery.
Reform legislation adds withdrawal management services to the Medicaid benefit set effective July 1, 2019 or upon federal approval, whichever is later. This program includes two levels of service: