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Medicaid MCOs

 

This section provides resources to Medicaid managed care organizations (MCOs) interested in covering the National Diabetes Prevention Program (National DPP) lifestyle change program.

Click here for a map to see if your state uses Medicaid managed care.

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Download a step-by-step (PDF) summary of how Medicaid MCOs can implement the National DPP lifestyle change program.

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Information in this section includes: Overview | Delivery Options | Screening & Identification | Recruitment & Referral | Enrollment, Incentives, & Retention | Network Management 

This section provides information on steps Medicaid MCOs should consider in offering the National DPP lifestyle change program. It also discusses practices that have been implemented in Medicaid and other contexts to enhance National DPP lifestyle change program delivery.

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Information in this section includes: Overview | State MCO Contract Amendments | Cost, Reimbursement & Rate-Setting Information | Contracting with CDC-Recognized Organizations | Medical Loss Ratio

This section provides information on how to incorporate references to the National DPP lifestyle change program in both MCO and CDC-recognized organization contracts. It also provides sample contract language and links to additional resources.

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Information in this section includes: Overview | Coding | 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 Medicaid data and reporting standards, and information on compliance issues and standards.