In July 2015, the Centers for Medicare & Medicaid Services (CMS) released a new 1115 demonstration waiver opportunity for states, generally known as substance use disorder (SUD) delivery system transformation. Under the delivery system, transformation states are encouraged to better identify consumers with substance use disorder, improve access to treatment, provide a comprehensive and effective array of services, and use quality metrics to evaluate the success of demonstrations. As part of the demonstration for participating states, CMS will waive the Institutions for Mental Diseases (IMD) exclusion rule that does not allow coverage of services for consumers aged 21-64 in . . .