Transforming Maternal Health Model-Provider Infrastructure Payments
TMAH-PIP
CSFA Number: 478-00-4037
STATE AGENCY INFORMATION
Agency Name
Department Of Healthcare And Family Services (478)
Agency Identification
Illinois Dept of Healthcare and Family Services
Agency Contact
PROGRAM INFORMATION
Short Description
The Transforming Maternal Health (TMaH) Model is a voluntary, 10-year service delivery and payment model designed to improve maternal health outcomes for people enrolled in Medicaid and the Children's Health Insurance Program (CHIP). The TMaH Model will test whether targeted technical assistance, coupled with payment and delivery system reforms, can drive a whole-person care-delivery approach to pregnancy, childbirth, and postpartum care while reducing Medicaid and CHIP program expenditures.
Federal Authorization
Section 1115A of the Social Security Act (the Act) establishes Centers for Medicare and Medicaid Innovation to test innovative health care payment and service delivery models that have the potential to lower Medicare, Medicaid, and CHIP spending while maintaining or improving the quality of beneficiaries’ care., Title Social Security Act, Section 1115A
Illinois Statue Authorization
N/A
Illinois Administrative Rules Authorization
N/A
Objective
These funds will support Provider Infrastructure Payments (PIPs), time-limited payments made to the TMaH Model Accountable Entities (AEs), hospitals and/or organizations that support AEs. The goal of PIP funding is to support care delivery improvements, data infrastructure improvement, expanded practice capacity, and capabilities needed to participate in the TMaH value-based payment (VBP) model.
UGA Program Terms
All relevant project requirements and definitions outlined in the opportunity apply to this award and have been incorporated into the Terms and Conditions of Award by reference.
Eligible Applicants
Nonprofit Organizations;
Applicant Eligibility
Federal funds were received by HFS as a State Medicaid Agency for the implementation of the TMaH Project in two test regions. Health System Partners that provide obstetrical services within Federal Qualified Health Centers and Hospital Systems settings and serving Medicaid Customers were selected as Participating Providers and Accountable Entities. These pre-selected Accountable Entities are eligible to receive funding.
Beneficiary Eligibility
The TMaH Project beneficiaries are Medicaid-eligible Customers who require Medicaid-approved services from Obstetrical partners providing prenatal, perinatal, and postpartum care for Medicaid and CHIP beneficiaries in TMaH test regions.
Types of Assistance
Project Grants
Subject / Service Area
Healthcare
Credentials / Documentation
Entity must be an eligible enrolled Medicaid provider
Registration and pre-qualification through the Grant Accountability and Transparency Act (GATA) Grantee Portal, www.grants.illinois.gov/portal.
Preapplication Coordination
Selected applicants will be contacted directly by the Department and provided additional information regarding the application requirements and necessary documentation needed to submit a complete application packet. The grantee will be required to demonstrate how it will spend the funds received. All applicants must be qualified to do business with the State of Illinois. To be qualified for a grant award, an entity must:
Have a valid DUNS number;
Have a current SAM.gov account;
Not be on the Federal Excluded Parties List;
Be in Good Standing with the Illinois Secretary of State, as applicable;
Not be on the Illinois Stop Payment list.
Not be on the Dept. of Healthcare and Family Services Provider Sanctions list
Application Procedures
Selected applicants will be contacted directly by the Department and provided additional information regarding the application requirements and necessary documentation needed to submit a complete application packet. The grantee will be required to demonstrate how it will spend the funds received. HFS will submit all complete applications to federal CMS for final approval.
Criteria Selecting Proposals
Health System Provider Partners were preselected and based on meeting at least 1,000 combined annual Medicaid births and located in the preselected TMaH Test regions. "
Award Procedures
Selected applicants will be contacted directly by the Department and provided additional information regarding the application requirements and necessary documentation needed to submit a complete application packet. The grantee will be required to demonstrate how it will spend the funds received. Health System Provider Partners were preselected and based meeting at least 1,000 combined annual Medicaid births, therefore there will not be a merit-based review process. Federal CMS will alo be reviewing and approving the application packet and funds will not be dispersed until approval from federal CMS is secured.
Deadlines
As identified in the Opportunity.
Range of Approval or Disapproval Time
Department approval or disapproval time could take up to 30 business days. Federal CMS review time could take an additional 60 days.
Renewals
Renewals based on Grant Funding.
Uses and Restrictions
Funds are used for Provider Infrastructure Payments, time-limited payments to TMaH Accountable Entities, hospitals, and/or organizations that support Accountable Entities to support health care delivery transformation activities within the following domains: 1) Patient Safety Initiatives and Maternal Care Assessment 2) Quality Measure Reporting and Value-Based Payment 3) Data Integration and Other Activities to Support Data-Driven Maternity Care 4) Team-Based Case 5) Enhanced Access to Care and 6) Connections to CBOs to Address Upstream Drivers of Health and Behavioral Health Needs.
Reports
Funded applicants will be required to abide by the grant agreement, submit Periodic Performance Report and Periodic Financial Report.
Audits
Grantees must comply with the audit requirements listed in 2 CFR 200 and Administrative Rule, 44 Illinois Administrative Code 7000.90.
Records
Records must be retained for three (3) years Financial records, supporting documents, statistical records, and all other non-Federal entity records pertinent to a Federal award must be retained for a period of three years from the date of submission of the final expenditure report or, for Federal awards that are renewed quarterly or annually, from the date of the submission of the quarterly or annual financial report, respectively, as reported to the HHS awarding agency or pass-through entity in the case of a subrecipient. HHS awarding agencies and pass-through entities must not impose any other record retention requirements upon non-Federal entities per 45 CFR §75.361 and see JCAR Title 44 Illinois Administrative Code 7000.430 Record Retention
Account Identification
0793-47865-4900-00-98
Obligations
Up to $10,837,885.28 to be distributed over six years.
Range and Average of Financial Assistance
HFS has received $17 million from the Center for Medicare and Medicaid Services (CMS) over a 10-year period.
Program Accomplishments
Provider Infrastructure Payments support health care delivery transformation activities within the following domains: 1) Patient Safety Initiatives and Maternal Care Assessment 2) Quality Measure Reporting and Value-Based Payment 3) Data Integration and Other Activities to Support Data-Driven Maternity Care 4) Team-Based Case 5) Enhanced Access to Care and 6) Connections to CBOs to Address Upstream Drivers of Health and Behavioral Health Needs.
Regulations, Guidelines, and Literature
45 CFR 75 and portions of 2 CFR part 200.
https://www.cms.gov/priorities/innovation/innovation-models/transforming-maternal-health-tmah-model
Regional or Local Assistance Location
Test Region 1: Rockford Region (Boone, Winnebago, and Northeast Ogle Counties)
Test Region 2: Northern Kane and Lake County, City of Elgin, and City of South Elgin
Comparison Region 1: Peoria and Tazewell County Region
Comparison Region 2: Aurora Region
Headquarters Office
Illinois Dept of Healthcare and Family Services
201 South Grand Ave E
Division of Medical Program Services
Springfield, IL 62763-1000
Program Website
Program specific page will be added to https://hfs.illinois.gov/
FUNDING INFORMATION
Funding By Fiscal Year
FY 2026 : $1,500,000
FY 2027 : $3,500,000
Federal Funding
Notice of Funding Opportunities
ACTIVE AWARDS