Medicaid covers peer-provider services in 37 states

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In 2018, Medicaid covered peer-provider services in 37 states for adults with substance use disorder (SUD), according to a U.S. Government Accountability study.

Peer providers are people who use their own experiences recovering from SUD to support others in recovery. Peer providers can be an important component of effective SUD treatment, the Centers for Medicare & Medicaid Services said in 2007.

The centers guided how states should cover peer support services in their Medicaid programs. States have flexibility in their Medicaid programs, and peer-support services coverage is an optional benefit.

The GAO obtained state-by-state data on peer-support services from the Medicaid and CHIP Payment and Access Commission and interviewed officials from Colorado, Missouri, and Oregon. GAO selected these states for several reasons, including to obtain variation in delivery systems used.

The officials said their state’s Medicaid programs offered peer-support services as a complement, not an alternative, to clinical treatment and that peer-support services could be offered as an alternative outside of Medicaid using state or grant funding.

Colorado and Oregon officials said peer-support services were only offered as part of a treatment plan while Missouri officials said peer providers worked in conjunction with doctors and other clinical staff.

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