1) Which Medicaid agencies are eligible to apply to participate in the TMaH Model?
All state Medicaid agencies (SMAs) for the 50 states, District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands are eligible to apply to participate in the model.
2) What types of technical assistance are available to states and providers to help implement TMaH?
Each awarded state Medicaid agency will receive 3 years of tailored technical assistance (TA), in one-on-one and group settings, from a team of policy and analytic experts. During the first quarter of the Pre-Implementation Period, a TA plan will be drafted collaboratively with the SMA awardee, CMS Innovation Center, and contracted TA coach.
The goal of the TA plan is to identify each awardee’s needs and to establish the right readiness steps to successfully implement the TMaH care delivery and payment model.
Topics may include:
- Quality measures
- Data analytics
- Payment model design and methodology
- Partnering with perinatal quality collaboratives and community-based groups
3) How much funding is available to support SMAs in achieving requirements?
Each awarded state Medicaid agency will be eligible for up to $17 million dollars during the model’s 10-year period.
4) What are the selection criteria for applicants?
Interested states must apply to the Notice of Funding Opportunity (NOFO) during the application period. A panel will review and score applications using a detailed rubric, which will be made available to all applicants as part of the NOFO. CMS will also consider the geographic diversity and scale of all applications when making final award determinations and select up to 15 recipients.
5) Will there be more than one opportunity for states to apply?
No, only one NOFO application period is currently planned.
6) How can providers in an awarded state participate in the model?
State Medicaid agencies will work directly with a variety of stakeholders and providers to implement aspects of the model. When the payment model begins, providers will need to be contracted with a managed care entity or directly with the Medicaid agency in a fee-for-service setting in the region that will be implementing the TMaH Model.
7) Will this model qualify as an Advanced or MIPS Alternative Payment Model (APM)?
TMaH is a Medicaid model and therefore is not an Advanced APM nor a MIPS APM.