Medicaid → Fiscal Operations
Fiscal Operations
This section features a variety of pages that focus on the operations of delivery and maintenance of the National Diabetes Prevention Program (National DPP) lifestyle change program through Medicaid. It includes examples of contract language and reimbursement models, information on coding and billing, and details on how data, reporting, and evaluation can be used to analyze and make improvements to the National DPP lifestyle change program.
This page provides sample language for state managed care organization (MCO) contracts as well as sample language and general guidance for contracts between MCOs and CDC-recognized organizations or UHOs.
This page provides information about cost and reimbursement for the National DPP lifestyle change program and can inform Medicaid agency and Medicaid MCO rate-setting and design delivery. It includes a summary table of all the reimbursement amounts used by states currently covering the program for Medicaid.
The purpose of this page is to provide information about coding and billing to ensure the National DPP lifestyle change program is reimbursed appropriately and in a timely manner. Correctly coding and billing for the National DPP lifestyle change program can also help drive quality and process improvements as well as meet compliance requirements in case of an audit.
This page features details on the types of data involved with the National DPP lifestyle change program and the processes and protocols by which that data is shared among parties. It also describes how these data and other sources can also be used in the evaluation of the National DPP lifestyle change program and associated pilots.
