NDPP Program Coverage Toolkit….Working With Payors!

Written by on 05/07/2019

In order to maintain a sustainable Diabetes Prevention Program, it’s crucial our DPP organizations/program leaders explore partnerships and reimbursement. This can include Employers, Commercial Plans, Medicaid, and Medicare–all of whom can help grow your rosters, thereby expanding the DPP, but also reimbursing the cost of your program, increasing sustainability!

But many are curious how to get this process started. Take a look at the State of Wellness Resources page https://www.stateofwellness.org/resources/>NDPP Toolkits>NDPP Coverage Toolkit. Here you will find a multitude of resources specific to your reimbursement/partnership questions.

As an example, scroll to “Commercial Plans–Learn More”. Once accessed, you will see detailed guidance on Medicaid and Medicare.  If you open “Commercial Plans”, this section provides resources about covering the National Diabetes Prevention Program (National DPP) lifestyle change program by commercial health insurance plans and employers.

Specifically:

  • Guide: a step-by-step (PDF) summary of how commercial plans and self-insured employers can implement the NDPP.
  • Employer:  specific information about employers covering the National DPP lifestyle change program.
  • Delivery: 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.
  • Contracting: information for commercial health insurance plans and employers on contracting with CDC-recognized organizations, program costs, and information on how the program impacts the medical loss ratio.
  • Coding/Billing: 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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