Medicaid and Corrections
Recent Medicaid guidance and legislative developments offer new opportunities for correctional leaders to leverage Medicaid to enhance outcomes for people who are incarcerated. With the passage of the SUPPORT Act, the Consolidated Appropriations Acts of 2023 and 2024, and new guidance around the Medicaid Section 1115 Reentry Demonstration Opportunity, prisons and jails have more opportunities to work with their state Medicaid agencies to support individuals not only during incarceration but also during the critical transition from incarceration to the community.
This webpage provides a curated list of resources to support correctional leaders in taking full advantage of these new opportunities.
Promising Practices
Below is a list of resources that specifically address Medicaid’s role in correctional systems. For additional information on best practices beyond what is listed here, we encourage you to explore the rest of the NRRC website, which contains a variety of useful resources to support broader reentry efforts.
- New Medicaid Opportunities to Support Youth Leaving Incarceration: Building Community Well-Being and Advancing Prevention Efforts, Center for Health Care Strategies, September 2024
- Provides guidance for states on leveraging Medicaid to improve transitions from incarceration for youth involved with the justice system; highlights best practices and practical steps for implementation, with an emphasis on youth and family involvement.
- Discussion Panel: Supporting Young Adults in Reentry through Medicaid Funding, CSG Justice Center, April 25, 2024
- Explores processes, strategic thinking, planning, and implementation work to meet Medicaid requirements for screening, referrals, and case management.
- Reentry Guide: Returning to the Community: Health Care after Incarceration – A Guide for Health Care Reentry, CMS Coverage to Care, April 2024
- Provides resources for people returning to the community after incarceration to connect with health care services.
- Report: Health Care Transitions for Individuals Returning to the Community from a Public Institution: Promising Practices Identified by the Medicaid Reentry Stakeholder Group, Office of the Assistant Secretary for Planning and Evaluation, January 26, 2023
- Summarizes the identified practices of the Medicaid Reentry Stakeholder Group and informs design of Medicaid Section 1115 Reentry Demonstration opportunities.
- Webinar: Medicaid Authority and Opportunity to Build New Programs for Justice-Involved Individuals, Health Management Associates, April 6, 2023
- Highlights opportunities to improve reentry outcomes through Section 1115 demonstrations and discusses early insights from the field.
- Highlights opportunities to improve reentry outcomes through Section 1115 demonstrations and discusses early insights from the field.
- Medications for Substance Use Disorders, Substance Abuse and Mental Health Services Administration
- Discusses the use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders; an additional FAQ explains the significance of the CAA’s removal of the requirement for practitioners to obtain a separate waiver to prescribe MAT for opioid use disorder (OUD).
- Substance Use Disorder Tools and Resources, Medicaid.gov
- Provides a collection of resources aimed at helping states manage and prevent substance use disorders, including guidance documents, best practices, and policy recommendations.
- Report: Recommendations for Medicaid Coverage of Opioid Use Disorder Services in Jails and Prisons, Health and Reentry Project, October 2023
- Outlines recommendations for implementation of OUD services in jails and prisons.
- Issue Brief: State Options to Increase Access to Medication-Assisted Treatment, National Conference of State Legislatures, August 31, 2023
- Outlines strategies states can use to improve MAT availability for OUD, such as removing prior authorization barriers, enhancing insurance coverage, and expanding treatment capacity through telehealth services, and highlights examples of state initiatives to support MAT.
- Report: Medicaid Section 1115 Waivers and Other Mechanisms to Support Service Expansion for Individuals with Substance Use Disorder and/or Justice System Involvement, BJA COSSUP, August 2023
- Highlights efforts in 11 states to expand access to health care services and other supports for Medicaid beneficiaries with substance use disorder in the justice system.
- Webinar: Medicaid 1115 Justice Waiver Opportunities: Medication-Assisted Treatment for SUD in Carceral Settings, Health Management Associates, July 13, 2023
- Discusses the implementation of MAT for SUD in carceral settings and focuses on MAT trends, building connections to community-based SUD care, and ensuring integrated, coordinated care for individuals returning to the community after incarceration.
- Discusses the implementation of MAT for SUD in carceral settings and focuses on MAT trends, building connections to community-based SUD care, and ensuring integrated, coordinated care for individuals returning to the community after incarceration.
- Policy Brief: A Roadmap to Evaluating 1115 Reentry Waiver Outcomes: Ensuring a Safe and Healthy Reentry from Incarceration to Communities, Transitions Clinic Network
- Provides guidance for program evaluation and quality measurement, informed by existing evidence, to assess the quality of care delivered to individuals involved in the justice system and the effectiveness of reentry waivers.
- Report: Recommendations for Medicaid Payment Models for Opioid Use Disorder Services in Jails and Prisons, Health and Reentry Project, January 2024
- Outlines four different payment models for Medicaid-covered opioid use disorder (OUD) treatment during incarceration and discusses options for reimbursement structures and options for quality incentives.
- Report: Recommendations for Medicaid Performance Measures for Opioid Use Disorder Services in Jails and Prisons, Health and Reentry Project, November 2023
- Outlines recommended Medicaid performance measures for OUD services in jails and prisons, including a review of existing measures, proposed Medicaid evaluation measures, and strategies for addressing OUD measures for state Medicaid agencies and correctional facilities.
- Tool: Social Determinants of Health Information Exchange Toolkit: Foundational Elements for Communities, Office of the National Coordinator for Health Information Technology, February 2023
- Provides information on the information exchange landscape for social determinants of health (SDOH), identifies approaches to advance SDOH information exchange goals, and provides examples of common challenges and opportunities.
- Policy Brief: Medicaid and the Criminal-Legal System: Health Information Technology, Community Oriented Correctional Health Services, March 2023
- Describes upcoming Medicaid policy developments and their implications for correctional-based information technology.
- Fact Sheet: 42 CFR Part 2 Final Rule, HHS, February 8, 2024
- Summarizes key legislative changes to federal requirements for confidentiality protections for people entering substance use disorder treatment.
