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Pennsylvania Keystones of Health Section 1115 Demonstration Approval Period: December 26, 2024 through December 31, 2029 Page 86 of 90 ATTACHMENT H Reentry Demonstration Initiative Services Covered Service Definition Case Management Every eligible reentry beneficiary will receive case management services within the 90 day pre-release window including evaluation of most recent needs/risk assessment; goal setting to address any identified gaps; providing access or information on resources/programs to close gaps; preparation for care handoff back into community setting with referrals/appointment setting at community providers; provision of education and informational materials to inmate about MA services eligibility and continued enrollment process within home county of release; verification that beneficiary has completed any outstanding medical and psychiatric follow-up appointments with DOC providers prior to release date; verification of comprehensive release packet at release to include pharmaceutical and medical supplies as ordered. Medication for Addiction Treatment Services Assessments, counseling, diagnostics, and medications available in the DOC to treat Opioid Use Disorder and Alcohol Use Disorder:

Buprenorphine - OUD (oral/injectable): a long-acting synthetic opiate partial agonist which prevents withdrawal, curbs cravings, and blocks the effects of illicit opioids. Methadone - OUD (oral): a long-acting synthetic opiate agonist which prevents withdrawal, curbs cravings, and blocks the effects of illicit opioids. Naltrexone - OUD/Alcoholism (oral/injectable): a long-acting synthetic opiate antagonist which prevents the euphoric effects of opioids and curbs cravings. 30-day Supply of Prescription Medications Medications: 30 day supply; Scheduled Controlled Medication: 30 day Supply; 340B Program Medications (Human Immunodeficiency Virus, Hepatitis B Virus, Hepatitis C Virus only): Send 90 day supply of medication and for HCV send all remaining doses to complete treatment; Psychotropic Medication: 60 day supply of medication, unless it is a controlled medication then send 30 day supply; no injectables given); MAT: Bridge medications to continue treatment until first community based appointment (No injectables given); PRN Medications: Only distributed if patient specific ordered (no stock meds distributed); OTC Medications: Only if patient specific ordered (no stock meds distributed).