ASAM Level of Care Certification: What to Know

ASAM Level of Care CertificationThe American Society of Addiction Medicine (ASAM) and the Commission on Accreditation of Rehab Facilities (CARF) have teamed up to roll out the ASAM Level of Care Certification at summer’s end.  Separate from, but complementing Accreditation, to obtain this Certification, addiction treatment facilities must adhere to adult residential treatment programs at 3.1, 3.5 and 3.7 levels of The ASAM Criteria.  Demonstrating the ability to deliver applicable level of care that is specifically based on patients’ severity of illness, and for the benefit and treatment of those suffering from substance abuse disorder, this Certification will require onsite surveys checking for “defining elements” that have not yet been disclosed.  Phase 1 of pilot surveys have been completed in February with Phase 2 set to begin in June and July.  Providers may apply to participate HERE

Once certified, providers can apply for recertification every three years and must submit an annual attestation of elements’ compliance and any Plan of Action implemented due to discovery and correction of deficiencies to CARF.  Although Certification may accompany Accreditation, it is not a prerequisite requirement for providers to be CARF Accredited (or Accredited by any other agency, i.e., TJC) to apply.  Training will be made available through ASAM in August, onsite surveys will be conducted by CARF.  Providing the appropriate Level of Care specific to individual patient’s needs, along with the facility’s correct ability to deliver different levels of care will be measured during surveys.  Although this level of care certification is for residential treatment and physical facilities will be viewed, Environment of Care components will not be specifically reviewed.  It was relayed that EOC components will remain with Accreditation, i.e., The Joint Commission.  Staff job descriptions, schedules, policies, procedures, and patient records are due to be reviewed and exhibited by the facilities’ capacity to provide that explicit Level of Care.  Upon completion of the onsite survey, it was estimated that the turn around time for approval or denial will be approximately two weeks.  Should deficiencies be found during the initial onsite survey, the facility will be able to make corrections and immediately re-apply through CARF for certification.

Partnering together, ASAM and CARF will help addiction treatment providers demonstrate treatment with appropriate levels of care using evidence-based guidelines, which should in turn assist the states in delivering high quality, cost effective access to treatment by Medicaid beneficiaries.  Using the ASAM Criteria and Level of Care Certification, treatment centers and providers will illustrate how they have implemented evidence-based treatment guidelines for compliance with Section 1115 Medicaid demonstration waivers.  Commercial payor sources should also recognize Level of Care Certified facilities for meeting medical necessity since The ASAM Criteria supports their services delivery with the “nationally recognized standard of addiction care.”[1]

[1] https://www.asam.org/docs/default-source/publications/asam-loc-program-faq-final-1-17-2018.pdf?sfvrsn=d0cd48c2_2

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