Since 2011, Maryland has drawn down the 50 percent federal match for quitline administrative costs (i.e., counseling services) for Medicaid enrollees who use the quitline. This cost-sharing program was authorized by CMS in 2011 and is also known as Medicaid Match and Federal Financial Participation (FFP). More recently, Maryland has streamlined access to all FDA approved cessation medications for Medicaid participants through a direct billing process which off-sets state costs for NRT. Ultimately, Maryland would like to use Medicaid cost savings to provide more robust quitline services to those callers who are under- or uninsured. These case studies of Maryland, North Carolina, and South Carolina highlight how they have developed cost-sharing partnerships with Medicaid.