According to the US Department of Health and Human Services (HHS), contingency management is widely considered the most effective treatment for stimulant use disorder, and also shows promise as an effective treatment for other forms of substance use disorder. Contingency management involves providing incentives — such as modest financial amounts on a gift card — as a way of reinforcing abstinence and other recovery-related behaviors. The DHCS began a pilot program in 2022 in a limited number of counties to further test the effectiveness of contingency management as a way of helping Medi-Cal beneficiaries overcome some forms of SUD. A report on the results is due in July 2024.
Despite contingency management’s demonstrated effectiveness, concerns about the potential application of certain federal fraud and abuse laws to contingency management programs limits its use. Providers offering supportive services, such as meals or transportation to medical appointments, will need to consider the applicability of the fraud and abuse legal authorities, like the Anti-Kickback Statute, and the safe harbor regulations to those services.