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​​1115 Behavioral Health Reform Medicaid Waiver

Medicaid Section 1115 Demonstration Waivers provide states with flexibility to test new approaches within Medicaid to aid in redesigning and improving their health systems without increasing costs.

How to get help

The Medicaid Services Section is available to help providers with Medicaid-related questions and offer technical assistance with facility waiver requests, billing, rates, or other questions related to the 1115 waiver process:, 907-269-3600,

1115 Waiver Demonstration Renewal

On March 26, 2024, Alaska received approval from Center for Medicare and Medicaid Services (CMS) to extend the 1115 demonstration waiver through December 31, 2028.  The extension authorized the state to change the title of the demonstration from “Substance Use Disorder Treatment and Behavioral health Program (SUD-BHP)” to “Behavioral Health Reform.”  The title change aligns mental health and SUD under a broader behavioral health definition to reflect the state’s commitment to program reform and system transformation.  Beyond the title change, the state did not request changes with this extension but rather sought to continue operations of the current demonstration.

Alaska’s 1115 Medicaid waiver, the Alaska Substance Use Disorder and Behavioral Health Program, was approved for the original demonstration period of January 1, 2019, through December 31, 2023. Alaska submitted a renewal application, in accordance with CMS requirements, to continue this demonstration for another five-year period, January 1, 2024 to December 31, 2028. CMS approved a temporary extension of the waiver demonstration until March 31, 2024 to allow additional time for the state and CMS to continue negotiations over the renewal application.

Alaska's 1115 Waiver

In January 2018, Alaska applied to the Centers for Medicare and Medicaid Services (CMS) for approval of an 1115 behavioral health waiver at the direction of the Alaska Legislature through SB 74. The intent was to create a data-driven, integrated behavioral health system of care for Alaskans experiencing serious mental illness, severe emotional disturbance, substance use disorder (SUD), co-occurring substance use and mental illness, and at-risk families and children.

At the guidance of CMS, the SUD component was broken out separately from the rest of the behavioral health services to move it forward more quickly in response to the growing opioid epidemic. It was approved in November 2018, with the implementation plan receiving approval in March 2019. The behavioral health component received approval in September 2019.  Alaska applied for the demonstration renewal in March 2023 for an additional five-year period.  CMS approved a temporary extension of the waiver demonstration through March 31, 2024 to allow additional time for the state and CMS to continue negotiations over the renewal application.  The extension approval was finalized on March 26, 2024 and provided for continued utilization of the demonstration waiver through December 31, 2028.

SUD component

Enhanced SUD services began in July 2019 with a phased-in approach to eligible providers. Details about the goals, outcomes and implementation of the program are available in the documents below

Provider and stakeholder engagement

Provider Forms

Quick Reference Documents

Section 1115 Waiver Update e-Memos

Look for the “Receive Updates” box at the top of any of these links and enter your email address to become a subscriber to these e-memos.

Roundtables: Feedback on the SUD implementation plan from providers across the state was gathered through roundtables. Topics discussed included screening and assessment tools, ASAM standards and training, expanding the use of pharmacotherapy, evidence-based practices, and qualified addiction professionals.

Infrastructure analysis: This project is evaluating regional hubs to determine if there is sufficient local infrastructure to provide the proposed services for each of the populations groups in the 1115 waiver. Service gap analyses are being developed for each region that compares current services to the proposed 1115 services.