Medicaid MCO Coverage of Quitline Services

To ensure Medicaid enrollees have access to comprehensive tobacco cessation benefit, including telephone counseling, some state quitlines have worked with their state Medicaid agency to include language in the Medicaid MCO RFP that requires coverage for quitline services.

NAQC has developed the following resources to guide other states:

• A Medicaid MCO RFP Toolkit, providing information on key steps in the process of working with a state Medicaid agency and links to existing resources. Click here for the full document.
• Recommend language for Medicaid MCO RFPs. Click here for the recommended language.
• Medicaid: NAQC Guidance for State Quitlines. This document was created to lay out the various mechanisms state quitlines can use to collaborate with state Medicaid agencies to improve cessation coverage for Medicaid enrollees, including access to state quitline services.
• Cost-Sharing Brief - Medicaid Reimbursement for Quitline Pharmacy Products. This brief identifies current processes, barriers, and breakthroughs, and “ideal” processes that may be considered when state quitline funders and service providers seek Medicaid reimbursement for pharmacotherapy. You can also review a NAQC webinar hosted on the same topic here. 

If you would like more information on efforts to work with Medicaid and Medicaid MCOs please contact Tracey Strader, Senior Program Manager, Public-Private Partnerships Initiative at tstrader@naquitline.org.

Medicaid Federal Financial Participation and State Quitlines

Over the past five years, quitlines throughout the U.S. have prioritized efforts to partner with state Medicaid agencies to increase awareness of, and access to, cessation services for Medicaid members. This work was bolstered by the June 24, 2011 Centers for Medicare and Medicaid Services (CMS) guidance that quitlines be recognized as an allowable Medicaid administrative cost expenditure, thus encouraging a new mechanism for cost-sharing for cessation.

In recent years, especially in light of the Affordable Care Act, quitlines’ focus on Medicaid has expanded from quitline referral and cost-sharing to ensuring that comprehensive coverage for cessation is included as a regular cost of health care for all Medicaid members. The current landscape of quitline efforts to build relationships and cost-sharing strategies with state Medicaid agencies, as well as critical questions for our work ahead, are highlighted in NAQC’s most recent report.

To support quitlines in the full range of Medicaid-related efforts, NAQC’s tools, resources, examples from practice and webinar slide decks are organized below in a series of building blocks. Each building block represents a stage of action, each one building toward the next. Simply click on a building block to get started!


Note: you will need to be signed into the NAQC website as a member to view certain resources. If you don't remember you member account password, please click on the "forgot your password?” link on the right of each website page (Direct link - https://naquitline.site-ym.com/general/email_pass.asp). Please have your username (usually an e-mail address) available for the password retrieval; it may take up to 15 minutes to receive an automated e-mail message; if you do not receive an e-mail in 15 minutes, please check your "spam/junk” folder or contact NAQC at membership@naquitline.org.