Assistance program
The Affordable Care Act Medicaid Incentives for Prevention of Chronic Disease Demonstration Project
-$4,701 committed in FY2018–FY2018
- Agency
- Centers for Medicare and Medicaid Services, Health and Human Services, Department of
- Assistance
- Project Grants
- CFDA number
- 93.536
- What it does
- Section 4108(a)(1)(A)The Secretary shall award grants to States to carry out initiatives to provide incentives to Medicaid beneficiaries who – (i) successfully participate in a program described in paragraph (3); and (ii) upon completion of such participation, demonstrate changes in health risk and outcomes, including the adoption and maintenance of healthy behaviors by meeting specific targets (as described in subsection (c)(2)). (a)(1)(B) The purpose of the initiatives under this section is to test approaches that may encourage behavior modification and determine scalable solutions. (a)(3)(A)The Secretary shall award grants to States to carry out initiatives to provide incentives to Medicaid beneficiaries who successfully participate in a comprehensive, evidence-based, widely available, and easily accessible program, proposed by the State and approved by the Secretary, that is designed and uniquely suited to address the needs of Medicaid beneficiaries and has demonstrated success in helping individuals achieve ceasing use of tobacco, controlling their weight, lowering cholesterol, lowering blood pressure, and avoiding onset of diabetes. (a)(3)(B) A program under this section may also address co-morbidities (including depression) that are related to any of the conditions described in subparagraph (A). (a)(3)(C) WAIVER AUTHORITY- The Secretary may waive the requirements of section 1902(a)(1) (relating to statewideness) of the Social Security Act for a State awarded a grant to conduct an initiative under this section and shall ensure that a State makes any program described in subparagraph (A) available and accessible to Medicaid beneficiaries. (a)(4)(D) FLEXIBILITY IN IMPLEMENTATION- A State may enter into arrangements with providers participating in Medicaid, community-based organizations, faith-based organizations, public-private partnerships, Indian tribes, or similar entities or organizations to carry out programs described in subparagraph (A). (d)(2) A State awarded a grant to conduct an initiative under this section shall develop and implement a system to—(1) track Medicaid beneficiary participation in the program and validate changes in health risk and outcomes with clinical data, including the adoption and maintenance of health behaviors by such beneficiaries; (2) to the extent practicable, establish standards and health status targets for Medicaid beneficiaries participating in the program and measure the degree to which such standards and targets are met; (3) evaluate the effectiveness of the program and provide the Secretary with such evaluations; (4) report to the Secretary on processes that have been developed and lessons learned from the program; and (5) report on preventive services as part of reporting on quality measures for Medicaid managed care programs.