Decision-making and motion planning are pivotal in ensuring the safety and efficiency of Autonomous Vehicles (AVs). Existing methodologies typically adopt two paradigms: decision then planning or generation then scoring. However, the former often struggles with misalignment between decisions and planning, while the latter encounters significant challenges in integrating short-term operational utility with long-term tactical efficacy. To address these issues, we introduce CALMM-Drive, a novel Confidence-Aware Large Multimodal Model (LMM) empowered Autonomous Driving framework. Our approach employs Top-K confidence elicitation, which facilitates the generation of multiple candidate decisions along with their confidence levels. Furthermore, we propose a novel planning module that integrates a diffusion model for trajectory generation and a hierarchical refinement process to find the optimal path. This framework enables the selection of the best plan accounting for both low-level solution quality and high-level tactical confidence, which mitigates the risks of one-shot decisions and overcomes the limitations induced by short-sighted scoring mechanisms. Comprehensive evaluations in nuPlan closed-loop simulation environments demonstrate the effectiveness of CALMM-Drive in achieving reliable and flexible driving performance, showcasing a significant advancement in the integration of uncertainty in LMM-empowered AVs. The code will be released upon acceptance.