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CMS Announces Maternal Opioid Misuse Model

The Centers for Medicare & Medicaid Services (CMS) has announced a new model to coordinate care for pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD). The Maternal Opioid Misuse (MOM) model will support the integration of clinical care with other services critical for health, well-being, and recovery.

The model, introduced through the CMS Innovation Center, aims to:

  • improve quality of care and reduce expenditures for pregnant and postpartum women with OUD, as well as their infants;
  • increase access to treatment, service-delivery capacity, and infrastructure based on state-specific needs; and
  • create sustainable coverage and payment strategies that support ongoing coordination and integration of care.

CMS will release a notice of funding opportunity early next year to solicit cooperative applicants to choose the model, of which CMS intends to select 12 cooperative agreements to execute with states. The model will last five years and include three distinct model periods: pre-implementation (Year 1), transition (Year 2), and full implementation (Years 3-5)

More information can be found on the CMS website and in an accompanying fact sheet.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Rachel Schwartz is a policy associate at America's Essential Hospitals.