Medicaid → State Stories of Medicaid Coverage

 

State Stories of Medicaid Coverage

 
Several states have elected to cover the National Diabetes Prevention Program (National DPP) lifestyle change program as a Medicaid covered benefit. The approaches these states took to achieve coverage may help other states think about how they could cover the lifestyle change program in their state Medicaid program. Click on a state below to learn more.

On February 2, 2022, Illinois, Maryland, New York, and Rhode Island participated in the CDC 1815/1817 grantee showcase where they summarized their journey towards Medicaid coverage of the National DPP lifestyle change program and shared key learnings. View a recording of the showcase below and download the slides here.

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Information in this section includes: The Challenge | The ProjectThe PartnersThe EvaluationAdditional Resources & Next Steps

This section describes the Medicaid Coverage for the National DPP Demonstration Project, a multi-year project carried out in Maryland and Oregon that was managed by NACDD and funded by CDC. The purpose of the Demonstration was to show how state Medicaid agencies and state health departments can collaborate to implement, deliver, and sustain coverage of the National DPP lifestyle change program.

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Learn how California used legislation and a state plan amendment (SPA) to move forward with Medicaid coverage of the National DPP lifestyle change program within the Medi-Cal fee-for-service (FFS) and managed care delivery systems.

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Illinois achieved Medicaid coverage for the National DPP lifestyle change program on August 1, 2021. Learn how ongoing engagement of governmental and non-governmental partners and an MCO mock claims pilot led to a SPA.

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NACDD, with funding from CDC, led the Medicaid Coverage for the National DPP Demonstration Project with Maryland and Oregon to show how state Medicaid agencies and state health departments can collaborate to implement, deliver, and sustain coverage of the National DPP lifestyle change program. This page describes how the Demonstration was implemented in Maryland and their plan for ongoing sustainability of the program beyond the Demonstration.

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Learn how Michigan is conducting a pilot with managed care organizations (MCOs) to offer the National DPP lifestyle change program to Medicaid beneficiaries throughout the state.

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Learn how Minnesota used its existing Medicaid State Plan to secure federal Medicaid matching funds for the National DPP lifestyle change program, and how it uses community health workers (CHWs) as lifestyle coaches.

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Learn how Montana used a SPA to move forward with Medicaid coverage of the National DPP lifestyle change program, and about Montana’s use of telehealth delivery of the program.

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Learn about New York State’s road to Medicaid coverage of the National DPP lifestyle change program, including its use of state legislation and a SPA.

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Ohio achieved Medicaid coverage for the National DPP lifestyle change program on December 17, 2021. Learn how various partners worked together to promote Medicaid reimbursement of the National DPP lifestyle change program through legislative approval of an Ohio Administrative Code rule change.

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NACDD, with funding from CDC, led the Medicaid Coverage for the National DPP Demonstration Project with Maryland and Oregon to show how state Medicaid agencies and state health departments can collaborate to implement, deliver, and sustain coverage of the National DPP lifestyle change program. This page describes how the Demonstration was implemented in Oregon and their plan for ongoing sustainability of the program beyond the Demonstration.

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Learn how Pennsylvania piloted the National DPP lifestyle change program with Medicaid managed care organizations (MCOs) before requiring the program’s inclusion in MCO services.

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Learn how the Wisconsin Department of Health Services (DHS) Chronic Disease Prevention Program (WI CDPP) and the Division of Medicaid Services (DMS) have worked together to prepare for Medicaid coverage for the National DPP lifestyle change program. Wisconsin is putting important infrastructure in place as it pursues statewide Medicaid coverage for the program by participating in technical assistance opportunities, developing a MCO pilot project, and creating a partner network.

Content Updated: February 9, 2024