Medicare → MDPP Implementation Resources
Medicare Diabetes Prevention Program (MDPP) Implementation Resources
The following tools, webinars and resources were developed as part of technical assistance for MDPP suppliers through funding and support by the Centers for Disease Control and Prevention (CDC) and implemented by the National Association of Chronic Disease Directors (NACDD). Some of the webinars and resources were developed in collaboration with the Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA). Webinar and resource topics include referrals and recruitment, marketing, promoting the MDPP, working with Medicare Advantage (MA) plans, and billing and claims.
To find more information about the MDPP and additional resources, visit our MDPP Basics page or CMS MDPP page.
This page contains the following topics:
- National DPP Business Tools
- MDPP Resources
- MDPP and State Health Departments
- MDPP and the PHE
- MDPP and Health Care Providers
National DPP Business Tools
Learn more about the DPP Revenue Projection Tool, Capacity Assessment Tools, and the Participant Enrollment Planning “PEP” Tool the on National DPP Business Tools on page of the Coverage Toolkit. These tools are designed to assist potential and existing MDPP suppliers to increase successful implementation of the MDPP.
MDPP Resources
CDC, CMS, AMA, NACDD, and other partners have worked collaboratively to host various informational webinars and learning opportunities geared towards promoting the MDPP. Please note that the resources below were developed for a specific technical assistance opportunity and often include titles and dates associated with that purpose; however, they can and should be used by any potential or existing MDPP supplier interested in learning more about how to be successful offering the MDPP.
The tabbed table below is organized by topic and lists the webinars with accompanying resources for each category.
Billing and Claims
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MDPP Billing Workshop FAQ (UPDATED) – Developed from a 2-part webinar series focused on increasing general knowledge about the MDPP billing and claims processes on September 22nd, 2021 (recording here), and November 10th, 2021 (recording here). This resource details attendee questions and answers from the webinar series. Updated April 2024. -
Lifecyle of an MDPP Claim Summary: Developed from a webinar NACDD and CDC hosted on November 16th, 2023 (recording here), this resource details best practices for following the three stages of the lifecycle -
Working with a Billing Vendor to Refine Electronic Health Record (EHR) Billing Processes for MDPP – Developed in the fall of 2022 from interviews with MDPP suppliers who were also participating in the MDPP Enrollment Project (please visit the NACDD MDPP Technical Assistance Offering Page to learn more about this project), this resource provides information on how MDPP suppliers can work with third-party billing vendors to improve EHR billing processes. -
Working with MACs – Developed from presentations during an informational webinar held on January 19th, 2022, where discussions focused on the basic functions and operations of a Medicare Administrative Contractor (MAC) and how they work with MDPP suppliers. This resource details what a MAC is along with the services they offer, best practices for working with a MAC, and resources to utilize when working with a MAC. -
MDPP Barriers and Potential Solutions – Developed from presentations during an informational webinar held on December 8th, 2021, where MDPP suppliers shared learnings on how to overcome challenges encountered when implementing and sustaining the MDPP. This resource details strategies shared to overcoming barriers with billing and claims, addressing differences between MDPP and the Diabetes Prevention Recognition Program (DPRP) standards, switching between delivery modalities, addressing administrative burdens, and sustainability. -
MDPP Enrollment Preparation Guide – Developed by CMS, this resource outlines the steps that organizations with preliminary or full CDC DPRP recognition status can follow to become an MDPP supplier. -
CMS MDPP Billing and Payment Fact Sheet – The MDPP payment rates are updated periodically and go through public commenting period before finalization
Referrals and Marketing
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Marketing the MDPP to Medicare Part B Beneficiaries – Find resources specific to marketing the MDPP to Medicare Part B beneficiaries and their health care providers from CDC.
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MDPP Referrals: Insights from Health Care Provider Champions – Developed from interviews NACDD conducted in June 2024 with four primary care and specialty providers who actively refer their eligible patients to MDPP suppliers, this resource seeks to describe referral practices, motivations, challenges, and suggestions from the health care provider perspective. -
MDPP SPARQ Project: MDPP Beneficiary Referral to Enrollment Case Studies – Through funding from the CDC, NACDD partnered with three MDPP suppliers that had high rates of referrals and enrollment as well as strong relationships with referring health care providers to implement the MDPP Sustainable Pathways for Accelerating Referrals of Quality (SPARQ) project. These case studies, published in October 2024, seek to tell their stories. -
Partnership Development to Increase MDPP Referrals and Marketing – Developed in the spring of 2023 from interviews with MDPP suppliers who were also participating in the MDPP Enrollment Project (please visit the NACDD MDPP Technical Assistance Offering page to learn more about this project), this resource provides information on how MDPP suppliers can partner with and market to other organizations within their community to increase referrals and enrollment into their programs.
Spotlight on the Oregon Wellness Network: Partnership Development – Developed in the spring of 2023 from an interview with an MDPP supplier, the Oregon Wellness Network (OWN), this resource provides information on how OWN works with partners and builds lasting relationships that further diabetes prevention efforts in the state of Oregon.
Creating EMR Referral Pathways for MDPP Summary – Developed from a two-part informational webinar series held on February 10th (recording here) and February 17th, 2023 (recording here), this resource describes how MDPP suppliers can create new referral pathways for the program, including creating a referral pathway through an EMR system.
Turning Referrals into Enrollment Summary – Developed from breakout sessions during an informational webinar held on October 4th, 2021, this resource details various best practices shared between MDPP suppliers for turning referrals into enrollment as well as possible solutions to barriers preventing an increase in enrollment.
MDPP Referrals Breakout Sessions Summary – Developed from breakout sessions during an informational webinar held on May 18th, 2021, where MDPP suppliers discussed together how to generate referrals into the MDPP. This resource details strategies shared to overcoming barriers with patient identification, referrals, and clinical team engagement.AMA Referrals Technical Assistance Informational Webinar – On February 23rd, 2021, CDC and NACDD hosted an informational webinar where AMA presented on increasing referrals into the MDPP.CDC Marketing Technical Assistance Informational Webinar – On January 26th, 2021, CDC and NACDD hosted a webinar where CDC presented on marketing strategies for the MDPP.
MDPP Beneficiary Recruitment Summary – Developed from an informational webinar held on October 20th, 2020 (recording here), this resource details strategies to increase recruitment into the MDPP. Various presenters shared information regarding targeted outreach campaigns, outreach to senior centers, identifying a clinical champion, and hosting an orientation or session zero. This resource was processed through CMS clearance and appears different from the other resources on this page.
MDPP Beneficiary Referrals Summary – Developed from an informational webinar held on October 20th, 2020 (recording here), this resource details strategies shared by various presenters on how to increase referrals into the MDPP. Ideas include building relationships with health care providers, optimizing your electronic health record (EHR), utilizing community advisory boards and community partnerships, and conducting primary care provider (PCP) letter campaigns. This resource was processed through CMS clearance and appears different from the other resources on this page.National DPP Customer Service Center – These materials can be used to help educate health care providers about the MDPP and provide them with tools to make it easier for them to refer eligible patients to the program.
Working with MA Plans
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MDPP Guide for Medicare Advantage Plans – This document provides an overview and value proposition for the MDPP for an MA plan audience and could be used to introduce an MA plan to the benefits of offering the MDPP. It summarizes key aspects of the MDPP benefit such as how the program is structured, administered, delivered, and certified, and it addresses how MA plans can work and contract with MDPP suppliers to offer the program to their members. -
Prospective Contract Components Between an MA Plan and an MDPP Supplier – This document shares illustrative examples of common elements that could be found in contracts between an MA plan and an MDPP supplier. Note: This document is intended to be educational in nature and does not constitute legal advice. -
MA Plan Finder and Beneficiary Estimation Instruction Guide – To seek reimbursement from MA plans, MDPP suppliers may need to contract with a specific plan and may be paid a negotiated payment rate for their services. This guide was developed to help programs find out 1) which MA plan(s) are in their geographic region and 2) approximately how many beneficiaries are enrolled in each plan. -
DPP Revenue Projection Tool – On the National DPP Business Tools website, there is an option to use the DPP Revenue Projection Tool to estimate revenue from a specific payer source, including an MA plan. An MA plan can also use this tool to estimate the costs of contracting with an MDPP supplier to provide MDPP services to their members. -
MDPP and MA Plans Summary – Developed from an NACDD-hosted informational webinar on December 15th, 2022 (recording here), during which Welld Health discussed MA plans and the different ways to work with them to successfully bill for MDPP services. -
Working with MA Plans Summary – Developed from an informational webinar held on April 28th, 2021 (recording here), this resource includes eight sections that detail information shared by various presenters including what MA is and how MDPP suppliers can contract and work with MA plans to increase MDPP enrollment. This resource was processed through CMS clearance and appears different from the other resources on this page. -
Questions or concerns about MA Plans and the MDPP? – If your organization needs information or assistance with MDPP payment policy or MA billing processes (such as determinations and appeals), you can submit your question(s) to CMS’s MDPP Supplier Support Center page at https://cmmi.my.site.com/mdpp/ and follow the steps provided to “Start a New Inquiry.”
Population at Greatest Risk for Diabetes
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Federally Qualified Health Centers (FQHCs) and MDPP – FQHCs are private or public non-profit health centers that provide services in areas where economic, geographic, and/or cultural barriers limit access to affordable health care services. FQHCs can also offer the MDPP, and the linked document provides guidance on how FQHCs can bill for MDPP services (#7, page 6). -
Scaling the MDPP with Populations at Greatest Risk for Diabetes Summary: Men, Dual Eligible, and People Living with Disabilities – Developed from an informational webinar held on March 8th, 2023 (recording here), this resource includes information shared by various presenters about ways to engage men, dual-eligible beneficiaries, and people living with disabilities in the MDPP. -
Scaling the MDPP with Populations at Greatest Risk for Diabetes Summary: Hispanic, Latino/a, and Spanish-origin Populations – Developed from an informational webinar held on November 8th, 2022 (recording here), this resource includes information shared by various presenters about ways to engage Hispanic, Latino/a, and Spanish-origin participants in the MDPP. -
Scaling the MDPP with Populations at Greatest Risk for Diabetes Summary: Asian and African American Populations – Developed from an informational webinar held on May 10th, 2022 (recording here), this resource includes information shared by various presenters about ways to engage African American and Asian American participants in the MDPP.
Overarching Resources
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Medicare 101 & MDPP – Medicare is a government-sponsored health insurance plan for people aged 65 or older. Medicare has various parts, and this document outlines the distinct parts of Medicare, what services they cover, the associated member cost sharing, and where the MDPP fits in. -
Increase Medicare Beneficiary Enrollment White Paper – NACDD through funding and guidance from the CDC, developed the MDPP Enrollment Project focused on increasing beneficiary enrollment in the MDPP by working directly with MDPP suppliers. A main takeaway was that MDPP suppliers and/or public health professionals benefited from tracking participant referrals and enrollment by referral source. Tracking this data showed the MDPP supplier which referral sources yielded the highest (or lowest) volume of MDPP enrollments and which referral sources produced the highest referral-to-enrollment conversion rates. MDPP suppliers can increase their financial viability by using referral and enrollment data. -
NACDD’s MDPP Enrollment Project Overview – From November 2020 to August 2023, NACDD’s Coverage Team focused efforts to increase Medicare beneficiary enrollment into the MDPP through the MDPP Enrollment Project. This project worked with over 60 MDPP suppliers in 27 states, and the planning and technical assistance team included NACDD, CDC, the AMA, Welld Health, and MDPP supplier peer mentors. -
MDPP All-Project Call Summary – On June 26th, 2023, NACDD hosted a call that promoted the sharing of best practices from various MDPP technical assistance offerings available to state health departments and MDPP suppliers (recording here). Participants provided an overview of successful initiatives to increase enrollment to and payment for the MDPP, and NACDD consultants reviewed available MDPP resources. CDC provided perspective on the program, and CMS joined to answer MDPP supplier’s questions. -
MDPP Enrollment Project Small Team TA Summary (2023) – As part of the MDPP Enrollment Project (please visit the NACDD MDPP Technical Assistance page to learn more about this project), NACDD selected a few MDPP Enrollment Project supplier awardees to serve as mentors and lead small group technical assistance calls, called “Small Team Technical Assistance (TA).” This summary resource describes the information that was shared during the Small Team TA meetings, and provides resources and solutions discussed in relation to each barrier. Information is categorized by topic area. -
National DPP Business Tools – Learn more about the customized National DPP Business Tools designed to assist potential and existing MDPP suppliers to increase successful implementation of the MDPP.
Potential New MDPP Suppliers
The resources and tools listed below are for organizations considering becoming an MDPP supplier or for new MDPP suppliers.
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Medicare 101 & MDPP – Medicare is a government-sponsored health insurance plan for people aged 65 or older. Medicare has various parts, and this document outlines the distinct parts of Medicare, what services they cover, the associated member cost sharing, and where the MDPP fits in.
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CMS MDPP: A Business Case for Prospective Suppliers – This resource covers a variety of subjects from a high-level overview of MDPP to the expected costs and revenue for delivering MDPP. -
MDPP Capacity Assessment Tool – Developed with input from experienced MDPP suppliers, this tool helps potential and existing MDPP suppliers identify areas to increase capacity for a more successful and sustainable program. This can also be used to assess capacity of subsidiaries for umbrella hub arrangements (UHAs). To learn more about UHAs, please visit the Umbrella Hub Arrangements pages of the Coverage Toolkit). -
Coverage Toolkit MDPP Basics Page – This page of the Coverage Toolkit gives a brief overview of the MDPP. It includes information about MDPP services and eligibility for beneficiaries and MDPP suppliers. Additionally, details about reimbursement for the MDPP, beneficiary incentives, and Medicare Advantage (MA) are included.
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CMS MDPP Page – This page describes the background of the MDPP and displays an interactive map of current MDPP supplier locations. CMS evaluation reports on the MDPP are provided along with an extensive list of links to CMS-developed resources to assist with MDPP orientation, CDC recognition for MDPP suppliers, and MDPP services.
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MDPP Orientation Video – Provides an overview of the MDPP for organizations interested in becoming suppliers.
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MDPP Enrollment Preparation Guide – Developed by CMS, this resource outlines the steps that organizations with preliminary or full CDC DPRP recognition status can follow to become an MDPP supplier.
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MDPP Supplier Learning Series Billing Workshop Part 1 – On September 22nd, 2021, CDC, CMS, and NACDD hosted part 1 of a 2-part webinar series focused on increasing general knowledge about the MDPP billing and claims processes. Part 1 specifically looked at how MDPP enrollment and the PECOS application processes impact billing.
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CMS MDPP Supplier Resources – This webpage provides more information and support for new and existing suppliers.
MDPP and State Health Departments
Successful implementation of the MDPP is a priority for state health departments (SHD). It is important for MDPP suppliers to know the roles of SHDs and learn more about how SHDs can support both suppliers and beneficiaries in their state. Please find the SHD Roles for Supporting MDPP Suppliers document, which reviews the ways in which SHDs can support the MDPP.
The MDPP Tracking Tool template can help state health departments understand past, current, and prospective MDPP suppliers in your communities, assess their unique strengths and challenges, and track their journeys to becoming successful and sustainable programs. This optional tracker, developed by CDC, the Diabetes MATCH Initiative and the National Association of Chronic Disease Directors (NACDD), gives a structured way to monitor MDPP availability, enrollment status, and key implementation details.
For those who would like an introduction to the MDPP or would like help with specific activities such as presenting the MDPP to leadership, onboarding new staff, or working with Medicare Advantage plans, below is a quick (~10 minute) video that reviews the basics of MDPP.
MDPP and the PHE
CMS has extended the rule that allows MDPP suppliers to use specific MDPP COVID-19 Public Health Emergency (PHE) flexibilities until December 31, 2029. This includes the option to deliver some or all MDPP sessions through distance learning. Additional information regarding the final rule can be found in here. Questions may be submitted through the MDPP Supplier Support Portal.
Resources:
- Navigating Your MDPP During the PHE Summary – Developed from an informational webinar held on January 19th, 2021 (recording here), various presenters shared how they have continued to offer the MDPP during the PHE. This resource details options for transitioning to virtual delivery, adapting to a new normal, and how to thrive not just survive during the PHE. This resource was processed through CMS clearance and appears different from the other resources on this page.
MDPP and Health Care Providers
The videos below were developed to encourage health care teams to work together and with their patients to identify prediabetes and increase referrals to the National DPP lifestyle change program. These videos were created by NACDD in collaboration with the AMA and through support from the CDC, Division of Diabetes Translation. CDC has also conducted research and tested materials to engage Advanced Practice Providers (AAPs) in referrals.Team-Based Care: Clinical Care Management and the National DPP
This video, based in a hospital, highlights the responsibility of care management in implementing and sustaining effective diabetes prevention strategies by health care providers, including referrals to the National DPP lifestyle change program.
Timing: 3:18 (Note: both Team-Based Care videos are the same until 1:16)
Audience: Clinical Care team (physician, medical assistant, front desk staff, care manager, practice manager, care coordinator, nurse, provider, etc.)
Team-Based Care: Clinical Care Team Roles and Responsibilities for Diabetes Prevention
This video, based in a clinical setting, explores the different roles health care team members can play in identifying patients with prediabetes and providing care and follow-up, including referrals to the National DPP lifestyle change program.
Timing: 4:05 (Note: both Team-Based Care videos are the same until 1:16)
Audience: Clinical Care team (physician, medical assistant, front desk staff, care manager, practice manager, care coordinator, nurse, provider, etc.)
Clinical Care: Prediabetes Identification and Treatment
This video illustrates how health care providers can help their patients address prediabetes through referral to the National DPP lifestyle change program.
Timing: 4:18
Audience: Clinical Care team (physician, nurse practitioner, physician’s assistant, nurse, medical assistance, care manager, care coordinator, etc.)
