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Commercial Health Plans & Employers

This section provides resources to commercial health insurance plans and employers interested in covering the National Diabetes Prevention Program (National DPP) lifestyle change program.

Download a step-by-step (PDF) summary of how commercial plans and self-insured employers can implement the National DPP lifestyle change program.

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Employer-sponsored health insurance is “commercial” coverage. As such, all of the subsections within Commercial Plans can be applied to both fully insured and self-insured employers. This section, however, provides specific information about employers covering the National DPP lifestyle change program.

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Information in this section includes: OverviewDelivery Options | Screening & Identification | Recruitment & Referral | Enrollment & Retention | Network Management

This section provides information on steps commercial plans and employers should consider in offering the National DPP lifestyle change program. It also discusses practices that have been implemented in commercial plan and employer contexts to enhance National DPP lifestyle change program delivery.

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Information in this section includes: OverviewContracting with CDC-Recognized Organizations | Cost & Reimbursement Information | Medical Loss Ratio

This section provides information on how commercial plans and employers can incorporate references to the National DPP lifestyle change program in contracts with third-party administrators (TPA) and CDC-recognized organizations. It also provides sample contract language and links to additional resources.

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Information in this section includes: OverviewCoding | Billing

This section includes information on the steps and considerations associated with coding and billing for the National DPP lifestyle change program, including the ICD and CPT codes currently being used for the program and a summary of their general operations.

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This section provides information on the type of data that needs to be reported to CDC’s Diabetes Prevention Recognition Program (DPRP), information on data and reporting standards used by commercial plans and employers, and information on compliance issues and standards.