Ohio Medicaid 1115 Reentry Waiver Stakeholder Discussions

The Ohio Department of Medicaid (ODM) hosted several stakeholder discussions as they are exploring opportunities presented by the 1115 Reentry Demonstration Waiver, which aims to test innovative service delivery strategies to improve care transitions for Medicaid eligible individuals leaving correctional settings and returning to the community.    This opportunity allows for a waiver of the inmate exclusion to receive Federal Financial Participation (FFP) for Medicaid expenditures for certain pre-release health care services provided to incarcerated individuals eligible prior to their release.

States participating in this waiver must provide the following pre-release services: case management and care coordination, MAT and counseling, 30-day supply of medication upon release. There are several other optional services that can be provided in the jail or prison either by their staff or through in-reach staff from community organizations. ODM is seeking additional information on the billing structure required under this waiver as the initial information appears to require the prison/jail to become a Medicaid provider to bill these services. Further potential complications related to this waiver include the requirement of an exact release date to initiate Medicaid coverage prior to release and a requirement to reinvest the total amount of federal funds received through the demonstration for any existing carceral healthcare services that are currently funded with state/local funds.

During these sessions, ODM provided an overview of the 1115 Reentry Waiver and gathered feedback and insights on how to facilitate successful reentry transitions for Medicaid-eligible individuals leaving prisons and jails and returning to the community. As ODM continues to contemplate this waiver and the challenges and opportunities of a re-entry demonstration project in Ohio, they are seeking feedback and questions from providers. If you have ideas to share with ODM related to this waiver, contact Kara Miller ([email protected]).