Centers for Medicare & Medicaid Services (CMS) Funding and Resources

Open Funding Opportunities

Funding to address substance use disorders (SUDs) and related issues. List may include programs with a primary purpose other than addressing SUDs.

Innovation in Behavioral Health (IBH) Model

Provides state Medicaid agencies with the opportunity to participate in a value-based payment model that will promote integrated behavioral healthcare delivery in outpatient settings for Medicaid, Medicare, and dually eligible beneficiaries with mental health and/or substance use disorders (SUDs). Seeks to align payment between Medicare and Medicaid for integrated services, with the goal of improving behavioral health access, quality, and outcomes for the target population. Tribal and rural providers may be selected to join the model as practice participants.

Letter of Intent (Optional): Sep 9, 2024
Application Deadline: Sep 9, 2024
Sponsor: Centers for Medicare & Medicaid Services (CMS)

Resources

CMS Letter to State Medicaid Directors: Leveraging Medicaid Technology to Address the Opioid Crisis

Offers states information and advice regarding strategies to combat the opioid crisis using technology, as well as potential funding opportunities for these efforts. Discusses implementing prescription drug monitoring programs (PDMPs) to track and facilitate the safe prescription of opioid medications and increasing data-driven approaches, interoperability, and telehealth services to improve care coordination among healthcare professionals.

Resource Type: Document / Report
Date: 06/2018
Sponsor: Centers for Medicare & Medicaid Services (CMS)
CMS Opioid Treatment Program Providers Dataset

Offers a dataset with information on Medicare-enrolled Opioid Treatment Program (OTP) providers that is updated monthly. Contains the name, National Provider Identifier (NPI), address, phone number, and the effective enrollment date for each provider. Includes resources for understanding and using the data.

Resource Type: Data
Date: 01/2024
Sponsor: Centers for Medicare & Medicaid Services (CMS)
CMS Roadmap: Strategy to Fight the Opioid Crisis

Describes the Centers for Medicare & Medicaid Services (CMS) activities to address the opioid epidemic related to prevention, treatment, and data. Highlights program successes, innovative approaches, and future goals of CMS efforts to address the opioid crisis.

Resource Type: Document / Report
Date: 06/2020
Sponsor: Centers for Medicare & Medicaid Services (CMS)
Evaluation of the Maternal Opioid Misuse (MOM) Model

Evaluates 7 states participating in CMS's Maternal Opioid Misuse (MOM) Model, which is designed to support delivery system transformation for pregnant and postpartum people enrolled in Medicaid who have opioid use disorder (OUD). Provides an overview of program activities for implementation year 2 from June 2022 to July 2023, including adoption, implementation, reach, and sustainability of the model, as well as the model's outcomes and effectiveness. Discusses barriers and other factors affecting care in rural areas.

Resource Type: Document / Report
Sponsor: Centers for Medicare & Medicaid Services (CMS)
Medicaid and CHIP Enrollees Who Received Mental Health or SUD Services in 2020

Provides data describing Medicaid and the Children's Health Insurance Program (CHIP) enrollees, ages 12 to 64, who received at least 1 mental health (MH) or substance use disorder (SUD) service paid for by Medicaid or CHIP in 2020. Supports CMS efforts to measure disparities in healthcare access and make targeted, data-informed investments to improve health equity for Medicaid and CHIP populations. Summarizes demographic trends among enrollees receiving SUD/MH services, including analysis by age, sex/gender identity, race/ethnicity, geographic area, primary language spoken, and eligibility category.

Resource Type: Document / Report
Date: 12/2023
Sponsor: Centers for Medicare & Medicaid Services (CMS)
Medicaid Opioid Prescribing Rates by Geography Dataset

Provides a dataset with comparisons of the number and percentage of Medicaid opioid prescriptions from each state. Includes an interactive mapping tool and resources for understanding and using the data.

Resource Type: Data
Date: 2021
Sponsor: Centers for Medicare & Medicaid Services (CMS)
Medicare Coverage of Services in Opioid Treatment Programs

Describes a benefit that covers opioid use disorder (OUD) treatment services under Medicare Part B medical insurance. Enables the Centers for Medicare & Medicaid Services (CMS) to make bundled payments to certified opioid treatment programs (OTPs) for OUD treatment services for an episode of care provided to Medicare Part B beneficiaries. Covers the following services under the benefit: opioid agonist and antagonist medication-assisted treatment (MAT) medications approved by the U.S. Food and Drug Administration (FDA), naloxone and overdose education, substance use counseling, individual and group therapy, toxicology testing, intake activities, and periodic assessments.

Resource Type: Website
Sponsor: Centers for Medicare & Medicaid Services (CMS)
Medicare Part D Opioid Prescribing Rates by Geography Dataset

Provides a dataset with comparisons of the number and percentage of Medicare Part D opioid prescriptions at the state, county, and ZIP code level. Includes an interactive mapping tool and resources for understanding and using the data.

Resource Type: Data
Date: 2021
Sponsor: Centers for Medicare & Medicaid Services (CMS)
Quality Payment Program (QPP) Small Practices

Offers technical assistance for clinicians in small, underserved, and rural practices to participate in the Centers for Medicare and Medicaid Services (CMS) Quality Payment Program (QPP), which establishes value-based payment systems and models for clinicians serving Medicare patients. Help participants understand QPP requirements, learn about flexible options for small practices, and implement measures to improve quality and efficiency.

Resource Type: Technical Assistance
Sponsor: Centers for Medicare & Medicaid Services (CMS)
Tribal Behavioral Health Service Locator

Directory of tribal behavioral health service providers that is searchable by state. Shares contact information, affiliation, and details the services available for each provider.

Resource Type: Treatment Provision
Sponsor: Centers for Medicare & Medicaid Services (CMS)