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Contingency Management for the Treatment of Substance Use Disorders: Enhancing Access, Quality, and Program Integrity for an Evidence-Based Intervention

Publication Date
U.S Department of Health and Human Services

Contingency management (CM) is an evidence-based psychosocial therapy for the treatment of stimulant use disorder, as well as a variety of other substance use disorders (SUDs), that is supported by three decades of research. Despite CM’s great potential and demonstrated effectiveness in improving the health and well-being of many people with SUDs, this proven treatment remains underutilized. Expanding access to high-quality CM services for the treatment of SUDs represents an important opportunity to accelerate efforts to address the overdose crisis, as well as the other substantial public health harms and costs related to untreated SUDs. In recognition of this opportunity, and to guide efforts by federal, state, local governments and other stakeholders, Section 4127 of the Consolidated Appropriations Act, 2023 (42 U.S.C. § 1320a-7d(a)(3)(B)), included a requirement for the Secretary of Health and Human Services and the Inspector General to “submit to Congress recommendations... for improving access to evidence-based contingency management interventions while ensuring quality of care, ensuring fidelity to evidence-based practices, and including strong program integrity safeguards that prevent increased waste, fraud, and abuse and prevent medically unnecessary or inappropriate items or services reimbursed in whole or in part by a federal health care program.” To respond to this provision, the HHS Workgroup on Implementation Strategies for Contingency Management has prepared this Report to Congress, which discusses opportunities and considerations for entities overseeing CM implementation, including regulators at the federal, state, Tribal, local and territorial levels; funders (e.g., grant making agencies, insurance companies); health care organizations; and health care providers.

This report is the result of collaboration between several HHS agencies and was prepared by the HHS/ASPE Office of Behavioral Health, Disability, and Aging Policy (BHDAP). Additional research in this area is available at the ASPE Behavioral Health page and ASPE Public Health page.

*This content is in the process of Section 508 review. If you need immediate assistance accessing this content, please submit a request to Brenda Veazey, Content will be updated pending the outcome of the Section 508 review.

Available Reports: