Video & Transcript Research : 'postpartum'
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OK
Oklahoma 2026 Regular Session
Senate Legislative Session Apr 8th, 2026 at 01:30 pm
Oklahoma Senate Floor Meeting
Keywords:
rural hospitals, small hospitals, grant program, healthcare funding, Oklahoma health department, cosmetology, barbering, massage therapy, State Board of Cosmetology and Barbering, Service Oklahoma, license renewal, license reinstatement, licensing fees, sunset extension, board membership, human trafficking, victim services, beauty school, barber school, esthetics
OK
Oklahoma 2026 Regular Session
Health and Human Services 2ND REVISED Apr 8th, 2026 at 10:00 am
Health and Human Services
Transcript Highlights:
- House Bill 3904 simply changes prenatal delivery and postpartum services from being a global payment
Keywords:
rural hospitals, small hospitals, grant program, healthcare funding, Oklahoma health department, cosmetology, barbering, massage therapy, State Board of Cosmetology and Barbering, Service Oklahoma, license renewal, license reinstatement, licensing fees, sunset extension, board membership, human trafficking, victim services, beauty school, barber school, esthetics
AL
Keywords:
consumer protection, app store, age verification, parental consent, data protection, minors, HB146, ivermectin, pharmacist, standing order, prescription drug, non-patient-specific order, dispensing, physician assistant, nurse practitioner, licensed health care provider, pharmacy board, medical licensure, disciplinary action, drug access
TX
Texas 89th Regular
Senate Committee on Health and Human Services (Part II) May 21st, 2025
Health & Human Services
Transcript Highlights:
- But again, the nurse practicing, like the nurse in a delivery room or the nurse caring for postpartum
Bills:
HB1106, HB3284, HB541, HB713, HB1403, HB1586, HB1942, HB2070, HB2844, HB2851, HB3151, HB3749, HB3940, HB3963, HB4454, HB4466, HB4795, HB5154, HB5394, SB1357, HB1052, HB4099, HB4638, HB5147
Keywords:
child abuse, neglect, gender identity, sexual orientation, child welfare, marriage, family, Texas Commission, family welfare, marriage support, stability, premarital education, child development, strong families, direct patient care, healthcare, physicians, medical services, insurance regulation, maternal health
TX
Texas 89th Regular
Senate Committee on Health and Human Services (Part I) May 21st, 2025
Health & Human Services
Bills:
HB1106, HB3284, HB541, HB713, HB1403, HB1586, HB1942, HB2070, HB2844, HB2851, HB3151, HB3749, HB3940, HB3963, HB4454, HB4466, HB4795, HB5154, HB5394, SB1357, HB1052, HB4099, HB4638, HB5147
Keywords:
child abuse, neglect, gender identity, sexual orientation, child welfare, marriage, family, Texas Commission, family welfare, marriage support, stability, premarital education, child development, strong families, direct patient care, healthcare, physicians, medical services, insurance regulation, maternal health
AL
Transcript Highlights:
- The bill requires the development of educational materials about postpartum depression, which would be
- Additionally, the bill requires physicians to assess mothers for postpartum depression.
- So, I'm not against screening mothers for postpartum depression.
- And so where this is headed is we're going to screen more people for postpartum depression.
- That you score above and they're not having any symptoms of postpartum depression.
Bills:
SB191, HB84, HB79, SB132, HB108, HB109, HB110, HB114, HB118, HB120, HB122, HB124, HB126, HB128, HB129, HB131
Keywords:
postpartum depression, mental health, Medicaid, screening, education, maternal health, Chiropractic, Board of Chiropractic Examiners, license renewal, continuing education, election procedures, off-label, pharmacists, medical treatment, state board of pharmacy, employment protection, SB132, Alabama, controlled substances, Schedule I
MA
Massachusetts 2025-2026 Regular Session
Ellen Story Commission on Postpartum Depression Jun 21st, 2026 at 04:00 pm
Transcript Highlights:
- The Ellen Story Commission for Postpartum Depression's spring meeting.
- postpartum period?
- But it does support screening for postpartum depression.
- appropriate codes to reimburse providers for covered postpartum screenings.
- I move that we adjourn this meeting of the Ellen Story Postpartum Commission.
Summary:
The Ellen Story Commission for Postpartum Depression held its spring meeting with a large turnout, beginning with roll call and a review of the agenda. Co-chairs Representative Brandy Fluker-Reid and Senator Liz Miranda highlighted progress from the recently enacted maternal health omnibus law and the Moms Matter Act, including creation of a midwifery board, expansion of out-of-hospital birth options, doula services, lactation support, MassHealth coverage changes, and a trust fund for community-based behavioral health and substance use grants. Members also discussed implementation of the new law, the commission’s annual report, and the need to continue supporting birth centers and perinatal mental health services.
A substantial portion of the meeting focused on commission membership and vacancies. Commissioners discussed whether to remain on the body, the need to fill several open seats, and whether the commission’s statutory composition should be updated to better reflect current practice and expertise. Members suggested adding more clinicians working directly with perinatal families, infant mental health experts, and a representative from PSI of Massachusetts, while also noting the value of having regulators and professional society representatives at the table. Several participants said any changes to membership would likely require legislation, and the co-chairs said they would explore options and possibly circulate a flyer or other invitation process for nominations.
The commission also discussed meeting structure and future planning. Members generally supported moving to quarterly virtual meetings, with a preference for a 4 p.m. start time, and some suggested one annual in-person gathering. The group agreed to postpone the usual May Advocacy Day because the Great Hall was unavailable and instead aim for a fall event, with volunteers stepping forward to help plan it. Commissioners raised top-of-mind issues including postpartum depression screening reimbursement, care for people after miscarriage or abortion, access for undocumented pregnant people, and the impact of federal cuts. The meeting ended with agreement to crowdsource legislative priorities for the next quarter, consider future presentations from outside organizations, and send updates between meetings, followed by a motion to adjourn that passed unanimously.
FL
Transcript Highlights:
- In the case of labor and delivery, there is no postpartum coverage in this coverage group.
- All right, moving to the next phase for the postpartum period.
- And Florida Medicaid provides 12 months of full-benefit postpartum coverage.
- , such as rewarding for completing postpartum visits between 7 and 84 days of delivery.
- And in pregnancy and postpartum, it's a major problem.
Summary:
The Senate Health Policy Committee met to discuss maternal and infant health, beginning with a presentation from New Jersey’s Maternal and Infant Health Innovation Authority (MiHA). Pamela Taylor described New Jersey’s statewide effort to reduce maternal mortality and racial disparities through the Nurture New Jersey campaign, a strategic plan with more than 80 recommendations, universal home visiting, Medicaid-covered doula care, hospital report cards, limits on non-medically indicated early elective C-sections, and a new maternal and infant health innovation center. Senators asked about doula certification, funding, home visiting, and how New Jersey coordinates across agencies; Taylor said the authority uses quarterly stakeholder meetings, annual summits, and a tracker for recommendations, and that community input helped shape its programs.
Florida Agency for Health Care Administration Deputy Secretary Brian Meyer then outlined Florida Medicaid’s maternal coverage and managed care structure. He reviewed eligibility and services for pregnant women, labor and delivery, postpartum coverage, newborn coverage, and family planning, noting 12 months of postpartum coverage, expanded benefits in managed care plans, and new contracts launching February 1 with more maternal-health-focused benefits, quality measures, and a new quality withhold incentive structure. Senators questioned doula certification and duplication with Healthy Start, provider access and network adequacy, kick payments, quality reporting, and whether Florida should consider broader eligibility standards; Meyer said many details are still plan-driven, that quality metrics are public, and that the agency is working on maternal-health work groups and incentives.
Department of Health Division Director Shea Holloway followed with an overview of Florida’s maternal and child health programs and data. She cited Florida CHARTS data showing pregnancy-related deaths, severe maternal morbidity, and infant mortality trends, and described the Title V block grant, the Maternal Mortality Review Committee, the Florida Perinatal Quality Collaborative, the electronic prenatal risk screen, Healthy Babies, BH Impact for perinatal mental health, Healthy Start, WIC, family planning, telehealth maternity care, and the Pregnancy Care Network. Senators asked about delays in mortality review reporting, preterm birth, substance use disorder in pregnancy, WIC participation, cesarean rates, and the impact of the abortion ban; Holloway said the department is continuing to monitor outcomes, expand screening and telehealth, and use data and hospital partnerships to improve care. The committee then adjourned without further business.
FL
Florida 2025 Regular Session
February 12, 2025 - 03:30 PM
Transcript Highlights:
- And the two common reasons why you have postpartum mortality after a mother has given birth are postpartum
- hypertension and postpartum hemorrhage.
- And the two common reasons why you have postpartum mortality after a mother has given birth is postpartum
- be postpartum hypertension.
- of these women in a postpartum area.
Summary:
The committee held a panel discussion focused on how Florida health care organizations are working to improve access, quality, and affordability. Panelists from Florida Community Care/Independent Living Systems, Sunshine Health, AdventHealth, UF Health, and Nemours described their approaches, including Medicaid managed care, value-based contracting, community partnerships, mobile screening units, smart-room technology, telehealth, and specialized programs for maternal health, children, and complex chronic conditions. Several speakers emphasized that managed care and coordinated care can improve outcomes while reducing unnecessary utilization and costs.
Members asked about the impact of Medicare’s V28 changes, mobile cancer screening, urgent care versus emergency room billing, pediatric specialty access, complaint resolution, Black maternal mortality, provider shortages, network adequacy, and the use of AI in prior authorization. Witnesses said V28 has affected providers and revenue, UF Health’s mobile screening program is expanding beyond a few cancer types, and its urgent care model bills patients at the appropriate level rather than both urgent care and ER rates. Nemours said it reduced specialty wait times through scheduling changes, telemedicine, and registry tools, while AdventHealth described postpartum coordination and maternal heart programs to reduce maternal complications and mortality.
On complaints and access problems, panelists said their organizations use patient/member advocates, care managers, call centers, and escalation processes to resolve issues, and Sunshine Health specifically discussed a transportation complaint that was addressed with its vendor and the family. Sunshine Health also said it is not using AI for prior authorization, though it is exploring responsible uses elsewhere, and Florida Community Care said it is not using AI in utilization management. In closing, panelists identified workforce shortages, provider burnout, and high-cost drugs as the biggest ongoing challenges. The meeting ended with thanks to the panel and adjournment after Representative Brackett moved to rise, without objection.
FL
Florida 2025 Regular Session
Health Policy Jan 14th, 2025
Transcript Highlights:
- So the prenatal period, labor and delivery postpartum and then the inter pregnancy in trouble.
- There is no postpartum coverage of this coverage group.
- Moving to the next phase for the postpartum period.
- Medicaid provides 12 months of full benefit postpartum coverage.
- Again, quality performance metrics during the postpartum period.
MS
Transcript Highlights:
- Um, this just requires health insurers to cover screenings of postpartum depression.
- It was a small carrier that did not cover postpartum depression screening.
- >> Next is Senate Bill 2708, uh, postpartum >> Next is Senate Bill 2708, uh, postpartum
- cover screenings of postpartum cover screenings of postpartum depression.<00:04:57.600>
Um - And um postpartum depression screening.
Summary:
The committee considered five bills. SB 2567, the Mississippi Pediatric Access to Critical Health Care Protection Act, would allow a border hospital to accept Medicaid patients and payments; it was moved as title sufficient and reported, with one member opposing. SB 2571, the Foster Youth Earn Benefit Protection for Success Act, would require Social Security survivor or disability benefits for foster youth to be used for the child rather than reimbursing the state for foster care costs; the sponsor said the bill follows federal guidance and other states’ practices, and it was reported after a title-sufficient motion, with one opposition.
SB 2708 would require insurers to cover postpartum depression screenings. Senator Boyd said most insurers already do this, and he offered an amendment to strike lines 364-368 because of concerns about step-therapy language; the committee adopted the amendment and then reported the bill. SB 2765 would open code sections related to DHS and Medicaid income verification so Mississippi can respond to federal error-rate penalties tied to SNAP and related programs; Senator Sparks said the state’s 10.69% error rate could trigger about $128 million in annual penalties, and members discussed whether the state’s change-reporting rules may be inflating that rate. The bill was reported.
The final bill, SB 2746, the Older Mississippians Act, was described by DHS as a cleanup measure that updates aging-services statutes, formally designates Mississippi as the state unit on aging, and removes obsolete program references. After brief discussion, it was reported on a title-sufficient motion. At the end of the meeting, Senator McMahan publicly thanked the chair for his work, and the committee then moved to rise and report.
CT
Connecticut 2026 Regular Session
Medical Assistance Program Oversight Council Women and Children's Health Committee May 11th Meeting May 11th, 2026
Transcript Highlights:
- They get it ahead of time, beginning in the second trimester, all the way to three months postpartum.
- The maternity episode begins 280 days before the pregnancy and goes to 90 days during the postpartum.
- ...days before the pregnancy and goes to 90 days during the postpartum.
- The need to support our pregnant and postpartum individuals who are struggling with mental health or
- So their pediatrician will administer an Edinburgh postpartum depression screening, recognizing that
Summary:
The meeting focused on maternal health and behavioral health services for pregnant and postpartum people in Connecticut. Dr. Fatmata Williams of DSS gave an update on the Husky maternity payment bundle, explaining that it was created in response to worsening maternal and neonatal outcomes and racial disparities. She said the bundle, launched in 2025, shifts payment away from fee-for-service toward prospective case rates, quality measures, and shared savings, while covering services such as doulas and maintaining access to behavioral health and other non-pregnancy-related care outside the bundle. She noted 26 maternity practices are participating, quarterly quality reports have been distributed, reconciliation is planned for 2026, and DSS is considering refinements such as adding newborns, revisiting shared losses, and possibly expanding to FQHCs after further stakeholder review.
Shelly Nolan of DMHAS then described the state’s women’s services and recovery continuum, including pregnant and parenting treatment programs, women’s recovery support programs, community transition support with rent subsidies, the Proud program, REACH navigation, recovery houses, and outpatient services. She emphasized that many programs are under capacity and that DMHAS uses a no-wrong-door approach, real-time bed availability, technical assistance, and training to improve access. She also reviewed initiatives tied to substance-exposed pregnancies and safe sleep, secure storage, naloxone distribution, reproductive health integration, breastfeeding support, and upcoming conferences and trainings. She said the department works closely with DCF and community partners to reduce stigma and improve family-centered care.
Beth Garrigan presented on the Access Mental Health and Substance Use for Moms program, a statewide consultation service for providers serving pregnant and postpartum individuals up to 12 months after delivery. She said the program offers real-time psychiatric consultation, referral support, and one-time face-to-face assessments, and has provided more than 4,300 consultations and resource/referral support to over 700 individuals since 2022. Members and legislators praised the service and discussed how it helps providers connect patients to care, follow up on referrals, and address barriers such as fit, stigma, and workflow. No votes were taken; the meeting ended with plans for the next meeting on June 8 and a request for Dr. Williams’ slides to be posted online.
MA
Massachusetts 2025-2026 Regular Session
Ellen Story Commission on Postpartum Depression Jun 21st, 2026 at 11:00 am
Transcript Highlights:
- Decker around the implementation of maternal health law, particularly for funding universal postpartum
- commission thinks that maybe we should send a letter to the conference committee as the Ellen Story Postpartum
- The wins are amazing and very certainly aligned and concordant with the Postpartum Depression Commission
- to include in our definition and efforts toward maternal mental health, mitigating the risks for postpartum
- which, though, yes, we think about mental health, is not helping the cause of getting people with postpartum
Summary:
The commission met to review the state budget process and discuss maternal and perinatal health funding. Members heard that the House did not adopt several maternal health amendments, including funding for community-based perinatal mental health grants, implementation of maternal health law items, private insurance coverage for midwifery care, a midwifery workforce development fund, birthing center grants, and the Tufts Center for Maternal Health Advancement. On the Senate side, several items were adopted, including funding for the Mass NOW menstrual equity program, $1 million for the Neighborhood Birth Center, and an out-of-state resident reproductive health training pilot; however, proposed funding for a midwifery workforce development fund, a health education trust fund, and the Tufts center was not adopted.
Commission members discussed whether to send a letter to the conference committee. Several members emphasized that while the Senate wins were positive, the commission’s core mission is perinatal and postpartum mental health, and that the letter should note the lack of explicit support for perinatal mental health and PMAD-related needs, as well as the importance of infant mental health and the parent-infant relationship. The commission voted unanimously to send a letter to the conference committee highlighting the broader maternal health wins while urging continued investment in perinatal and postpartum supports.
The meeting also covered commission vacancies and future planning. Staff reviewed open seats, including a House minority seat, several governor-appointed seats, an optional commissioner seat, and appointments for the Senate and House co-chairs. Members suggested possible representation from the Children’s Trust, families impacted by addiction, and midwifery. The commission also noted that April and June meeting minutes would be circulated for later approval, and that the legislative session is nearing its end with several pending bills related to perinatal mood disorders and postpartum issues. The meeting adjourned after no further new business.
TX
Texas 89th Regular
S/C on Disease Prevention & Women's & Children's Health Apr 24th, 2025
S/C on Disease Prevention & Women's & Children's Health
Transcript Highlights:
- Same thing in pregnancy and postpartum.
- They're typically getting one to two postpartum visits with their OBGYN.
- She was able to go to the hospital and was admitted for postpartum preeclampsia and immediately put on
- These families have experienced physical and mental trauma during pregnancy, labor, and postpartum.
- During pregnancy, they can act as an educator, and during postpartum...
Keywords:
maternal health, mortality review, health committee, obstetrics, public health, Medicaid, cancer treatment, healthcare reimbursement, physical therapy, dental services, protheses, compression garments, mortality, morbidity, doula services, disparities, Black women, maternal mortality, health disparities, socioeconomic status
MA
Massachusetts 2025-2026 Regular Session
Joint Committee on Financial Services Jun 21st, 2026 at 10:30 am
Joint Committee on Financial Services
Transcript Highlights:
- For infants, this includes parental postpartum mental health concerns.
- Roughly 85% of postpartum people experience some type of mood disturbance.
- I also treat older kids who have experienced stressors like postpartum depression and anxiety for years
- We work on improving awareness and resources for parents in Massachusetts facing postpartum depression
- In Massachusetts, parents have coverage for postpartum physical care. Thank you.
Summary:
The committee held a hearing on a large group of behavioral health and insurance-related bills. Topics included expanding access to mental health services by allowing physician assistants to authorize Section 12 emergency holds and be recognized as licensed mental health professionals (H. 1131/S. 773); improving coverage for community behavioral health centers so commercial insurance matches MassHealth’s bundled outpatient and crisis services (H. 1276/S. 703); eliminating cost sharing for certain behavioral health services (S. 718); extending detox and clinical stabilization coverage from 14 to 30 days and adding transitional support services (H. 1319/S. 772); requiring coverage for dual-diagnosis treatment in psychiatric facilities (H. 1277/S. 771); and preserving access to treatment for serious mental illness through coverage of coordinated specialty care and assertive community treatment (H. 1135/S. 709). The committee also heard bills on preventive behavioral health services for children (H. 1228/S. 802) and post-pregnancy mental health care, including postpartum depression and pregnancy loss-related care (H. 1314/S. 823).
TX
Texas 89th 2nd C.S.
S/C on Disease Prevention & Women's & Children's Health Apr 24th, 2025
S/C on Disease Prevention & Women's & Children's Health
Transcript Highlights:
- Same thing with in pregnancy and postpartum.
- They're typically getting 1 to 2 postpartum visits with their OB-GYN, but then they're coming back to
- , um, their doula and they're going to reveal to their doula other postpartum complications or health
- For example, I had a family that I supported a year ago, who, um, in the postpartum visit, which was
- She was admitted for postpartum preeclampsia and immediately put on magnesium.
MA
Massachusetts 2025-2026 Regular Session
Ellen Story Commission on Postpartum Depression Jun 21st, 2026 at 11:00 am
Transcript Highlights:
- , we'll pass it along to Senator Adam Gomez, our new co-chair of the Ellen Surrey Commission on Postpartum
- more of an active commission with better information sharing about what's happening as early to postpartum
- I have personally treated a number of women, they happen to be women, birthing parents, for postpartum
- Because we know that that places higher risk for the development of a postpartum mood disorder.
- I know Faiola had a bill related to the postpartum pediatric screening.
Summary:
The commission met to reopen its work for the year, with roll call and attendance confirmations followed by remarks from the co-chairs and members. Senator Liz Miranda stepped down as co-chair, citing multiple responsibilities and personal losses, and Senator Adam Gomez was welcomed as the new Senate co-chair. Gomez said he would listen and learn from commissioners and advocates, and both outgoing and incoming leaders emphasized continuing the commission’s work on maternal health, postpartum depression, and equity.
Members discussed several current policy and implementation issues. The Department of Public Health reported a new regulation to implement the 2024 midwifery access law, including temporary licenses for licensed certified professional midwives. Commissioners also raised concerns about birthing hospital and inpatient obstetric unit closures, OB-GYN workforce shortages, reimbursement changes, and the need to expand midwifery, doula, and birth center capacity. Other topics included substance use and perinatal mental health supports, the limited $220,000 appropriation for community-based perinatal mental health organizations, and the need for stronger funding in the budget to implement the maternal health law.
The commission also focused on future priorities and information sharing. Members suggested more presentations from clinicians, regulators, infant and early childhood mental health experts, and PSI of Massachusetts; greater attention to parent-child relational health and postpartum screening in pediatric settings; and possible commission action such as a letter to the governor on workforce and access issues. The group agreed that there was not enough time to plan a May event and instead would use the commission to publicize related events, including Black Maternal Health Week activities. Commissioners voted to create a biweekly digest for sharing updates, with urgent items to be sent by email, and then adjourned the meeting.
NH
New Hampshire 2026 Regular Session
Health and Human Services Oversight Committee (02/20/2026)
Transcript Highlights:
- year, that has made it be that we don't have any deaths in 2024, 2025 from postpartum overdose.
- It is a logical postpartum year.
- services through the full postpartum services through the full postpartum year<00:52:27.119>
- 2025 from postpartum<00:52:35.520>
overdose. - So because there postpartum overdose.
Summary:
The meeting opened without a quorum, so approval of the prior draft minutes was deferred until later. The committee then heard a DHS update from Commissioner Lori Weaver and COO David Weers, who described the recent flood at the Brown building and the relocation of nearly 400 DHS staff while operations are restored. They also outlined New Hampshire Care Connections, a privacy- and consent-focused closed-loop referral platform intended to improve referrals among providers, reduce duplication, and support continuity of care, with an Upper Valley implementation partnered with Dartmouth Health and an Epic integration already underway.
Members asked whether the system would merge medical records or simply track referrals. DHS said it is not intended to store or transmit full medical records, but to integrate with providers’ electronic health record systems so referrals can be sent, received, and tracked, with consent controls limiting what information can be shared. Officials said the project will be tested over the coming months, with metrics, governance, and advisory committee oversight, and that it is tied to broader rural health transformation efforts and statewide implementation after the regional pilot.
The committee also received the annual report from the Child Care Advisory Council. Maryanne Barter and Jessica Carver said the council worked with licensing to streamline the child care licensing rules, reducing the handbook by about 30%, and is now helping develop an informal dispute resolution process, revising the Granite Steps for Quality system, and creating a clearer handbook for providers handling state scholarship audits. They reported ongoing concern about child care closures and workforce shortages, said there is currently no wait list for child care assistance, and discussed questions about federal CCDF immunization requirements, which DHS said it would follow up on with federal technical assistance partners. After quorum was established, the committee moved to approve the minutes from the prior meeting.
NH
New Hampshire 2025 Regular Session
Senate Health and Human Services (02/18/2025)
Health and Human Services
Transcript Highlights:
- more apt to experience postpartum more apt to experience postpartum depression<00:28:55.279>
- Postpartum rates are unfortunately so high that it's become synonymous with postpartum, like, 'Oh, I
- had postpartum, and it was really bad.'
- abuse uh disorder and postpartum abuse uh disorder and postpartum depression<01:12:27.600>
so - mental health crashed postpartum mental health crashed postpartum depression<01:16:03.080>
anxiety
KY
Kentucky 2025 Regular Session
Medicaid Oversight and Advisory Board (12-10-25)
Transcript Highlights:
- Uh a also pre and postpartum doulas.
- 57% lower odds of postpartum depression. 57% lower odds of postpartum depression. federal<01:10:
- that they've done to expand postpartum that they've done to expand postpartum Medicaid<01:15:31.440
- after 12 months 12 months postpartum. after 12 months 12 months postpartum.
- recognizes the timeline of postpartum recognizes the timeline of postpartum recovery.<01:20:38.080
Summary:
The Medicaid Oversight Advisory Board met with a quorum, approved the November 12 minutes by voice vote, and then heard a presentation from former Governor Ernie Fletcher and Dave Johnson on Medicaid reimbursement for substance use disorder (SUD) treatment. Fletcher argued that addiction should be treated as a chronic disease requiring a longer continuum of care, not just short residential stays, and said recovery should combine clinical treatment with social supports such as housing, transportation, employment, peer coaching, and recovery housing. He cited data on overdose trends, low treatment rates, and high costs for people with SUD, and said current reimbursement models create poor incentives and do not adequately support long-term recovery or measure outcomes well.
Fletcher proposed a “carve through” model administered at the MCO level with standardized metrics, data sharing, and an independent recovery coordinator that would assess patients, coordinate care, and connect them to clinical and social recovery services. He suggested using bundled payments, shared savings, and partial risk arrangements, with recovery housing reimbursed on a PMPM or weekly basis and funded in part through existing Medicaid spending and other sources such as opioid abatement funds. He also emphasized peer support, telemedicine, criminal justice coordination, workforce and education supports, and the use of technology, including text messaging and possibly AI, to maintain long-term follow-up and identify relapse risk.
Members questioned how the model would work in practice, especially the education and staffing requirements for recovery coordinators, reimbursement levels, and how many patients each coordinator or peer would serve. Fletcher said peers could be certified and would need additional training in assessments such as ASAM and recovery residence standards, but he did not give a precise salary figure, saying the market and bundled rates would determine that. He also said follow-up should continue for years, noting relapse risk over the first 18 to 24 months and that meaningful employment and ongoing peer contact help sustain recovery. No formal vote or action was taken on the substance use presentation.