Among the priorities for public health agencies today is sustaining and diversifying programmatic funding. Fortunately, there is a funding stream that is supporting a growing number of health departments, which can provide considerable federal funding for IIS. That funding stream is administered by the Centers for Medicare and Medicaid Services (CMS) and goes by several names, including “CMS 90-10 Matching Funding Program,” the “HITECH/HIE Federal Financial Participation program,” or simply “the 90-10 funding program.” Under this program, CMS will pay 90% of approved costs for approved activities if the 10% match comes from non-federal funds. While CMS supports several 90-10 Federal Financial Participation programs, this guidance is focused on the HITECH/HIE program aimed at supporting Meaningful Use and health information exchange.


Beneath that simple and promising statement is a fair bit of planning complexity. The purpose of this guidance is to unravel some of that complexity and to prepare you with the information you need to make an informed, credible and effective overture to your Medicaid program about applying for these funds.

This guidance is designed for those who are new to this CMS funding stream, and perhaps also new to working with their state’s Medicaid program. Medicaid operates much differently than public health in many respects, even though they share similar missions and population health goals. This guidance is focused on the first step in the graphic below: Getting Ready to Work with Medicaid. It supports the initial planning steps internal to your agency prior to approaching the Medicaid program. Within that first step are five modules, most with their own tip sheet and worksheet, to support your information gathering and planning.


While Medicaid is being encouraged to work with public health on Meaningful Use and other priorities, the reality is that Medicaid has many priorities now as it seeks to transform the health care system. The key to successful collaboration is being prepared, informed and credible. This toolkit can help you do that by providing the information you should know—and the information you could collect—prior to reaching out to your Medicaid colleagues.

Although the tip sheets and worksheets in this toolkit provide glimpses into the second through fourth stages of the entire process, it is focused on the first step only. Once you have begun to work with the Medicaid program, your guidance will come from them on each of your next steps and the information you need to provide.

Clicking on the tools in the graphic above will prompt file download. Alternatively, downloads of these files are available here.

Much of the advice contained here comes from your peers, gathered through interviews conducted by either the Association of State and Territorial Health Officials or by the Public Health Informatics Institute, working in collaboration with the Association of Immunization Managers and the American Immunization Registry Association. This guidance also includes information from the Office of the National Coordinator for Health IT (ONC) webinar series on the CMS 90-10 funding program. CDC and ASTHO have also developed a series of short fact sheets on the different funding mechanisms available through Medicaid, available on the ASTHO website.


Click each category to expand.

State Medicaid Directors Letter #16-03: February 2016

This letter addresses the subject “Availability of HITECH administrative matching funds to help professionals and hospitals eligible for Medicaid EHR incentive payments connect to other Medicaid providers.”

CMS FAQ: September 2013

CMS offers answers to frequently asked questions about the 90-10 funding stream.

State Medicaid Directors Letter #11-004: May 2011

This letter addresses the subject “Use of administrative funds to support health information exchange as part of the Medicaid EHR incentive program.”

State Medicaid Directors Letter #10-016: August 2010

This letter addresses the subject “Federal funding for Medicaid HIT activities.”

State Medicaid Directors Letter #09-006: September 2009

This early letter provided initial guidance on funding related to the HITECH act.

HITECH, Meaningful Use, and Public Health: Funding Opportunities for State Immunization Registries

Released by CMS in May 2011, this paper describes strategies to help states fund the development and maintenance of their immunization registries. 

A Step-by-Step Guide for Health Departments Seeking HIT/HIE Funding Via the 90/10 Medicaid Match

This draft guidance document walks health departments through the steps of securing Medicaid 90/10 Match funding.

Expanded Support for Medicaid Health Information Exchanges

This presentation from 2016 was given by Thomas Novak, the Medicaid Interoperability Lead at CMS, provides an overview of funding for Medicaid HIEs.

Federal Financial Participation for HIT and HIE

This CMS webpage shows a map of states where HIE Implementation Advanced Planning Documents (HIE IAPDs) have been approved or are in first time review process. 

Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap, Version 1.0

This document identifies short-term actions that can be taken before the end of 2017 to make progress toward interoperability.

State Health Information Exchange Cooperative Agreement Program Key Contacts

CMS makes avaiable contact information for state HIT coordinators, state health information exchange cooperative agreement program grantees and contact people for direct services.

State Experiences with HITECH Federal Financial Participation Opportunities for Public Health Related Activities

ASTHO released a report providing an overview of the Medicaid funding opportunity provided through the HITECH Act, as well as lessons learned and recommendations from states that have applied for and implemented the funding.

Maximizing Public Health Partnerships with Medicaid to Improve Health toolkit

A toolkit from ASTHO, this collection of resources identifyies specific opportunities, challenges and solutions for promoting increased collaboration between Medicaid and public health.

Case Study: Washington’s Experience Securing Medicaid 90/10 Match Funds

In this case study, Washington state shares lessons learned in applying for Medicaid 90/10 match funding.

Sample IIS reports for Medicaid providers and plans from the state of Michigan

IIS and HIE: Is there a Future Together?

From HLN Consulting, this report describes the developing HIE landscape (including current HIE collaboration with IIS) and offers commentary on the future of IIS-HIE collaboration.

This guidance was made possible through cooperative agreement no. HM08-080502CONT12 from the Centers for Disease Control and Prevention (CDC) National Center for Immunization and Respiratory Diseases. Any portions of this toolkit may be re-used; attribution is requested. Please cite “Planning Guidance for Preparing to Access CMS 90-10 Funding for Public Health, PHII, 2016.”