Affordable Care Act State Health Insurance Assistance Program (SHIP) and Aging and Disability Resource Center (ADRC) Options Counseling for Medicare-Medicaid Individuals in States with Approved Financial Alignment Models

 

The goal of this Funding Opportunity is to provide funding over a three year period to states that have signed a Memorandum of Understanding (MOU) with CMS to implement a CMS-approved State Financial Alignment Initiative. In April 2011, the Medicare-Medicaid Coordination Office awarded design contracts to 15 states to implement State Demonstrations to Integrate Care for Medicare-Medicaid Individuals. Subsequently, CMS released a letter to State Medicaid Directors which discussed two models for integrating care and aligning financial incentives for Medicare and Medicaid as part of CMS’ Financial Alignment Initiative, a joint initiative of the Innovation Center and the Medicare Medicaid Coordination Office, under which States and CMS will collaborate to integrate care and financing for Medicare-Medicaid individuals. The Financial Alignment Initiative is a unique Federal-state partnership to test aligning the service delivery and financing of the Medicare and Medicaid programs to better serve Medicare-Medicaid individuals. As part of this effort, there is a need for strong beneficiary support education and outreach in each State that is implementing a Financial Alignment model, including options counseling for beneficiaries.

Awardees will develop and implement a coordinated SHIP/ADRC strategy and action plan to provide beneficiaries who are eligible for both Medicare and Medicaid – during both the Phase 1 Activities and Ongoing Activities of the program, as described in the funding opportunity announcement - with objective information and one-on-one counseling on the nature of the state’s Financial Alignment model. Such activities will include, but are not limited to, providing information and counseling as to how and when the project will be implemented, the options these dual eligible beneficiaries will have for receiving their Medicare and Medicaid services in their state, the appeal rights they will have under the model, and what they need to do to participate in the program. The SHIP/ADRC staff assigned to this project must be able to provide this information and counseling in a way that is easy for beneficiaries to understand and is culturally and linguistically appropriate. These activities must be carried out in a SHIP/ADRC. Also, the SHIP/ADRC should possess a basic understanding of all CMS approved State Financial Alignment Initiatives.

Deleted 04/02/2020 (Archived.) 93.626 Agency: Department of Health and Human Services
Office: Centers for Medicare and Medicaid Services Project Grants Not Applicable. This solicitation is being issued under section 1115A of the Social Security Act (added by section 3021 of the Patient Protection and Affordable Care Act (P.L. 111-148)), which authorizes the Innovation Center to test innovative payment and service delivery models to reduce program expenditures under Medicare, Medicaid, and the Children’s Health Insurance Program while preserving or enhancing the quality of care. Eligible applicants from the CMS-approved Financial Alignment States include any one of the State agencies that administers the ADRC and/or SHIP programs(s) within the State (e.g. State Unit on Aging, State Department of Insurance, a State Disability Agency, State Medicaid Agency or other State entity). State Medicaid Agencies and the Medicaid Agencies in the Federal Territories – This cooperative agreement only serves beneficiaries that are dually eligible for Medicare and Medicaid coverage. Yes. In order to apply, applicants must include a copy of the signed MOU with CMS to implement an approved Financial Alignment model. 2 CFR 200, Subpart E - Cost Principles applies to this program. Preapplication coordination is required. Environmental impact information is not required for this program. This program is excluded from coverage under E.O. 12372. 2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program. The standard application form SF-424 and related forms must be used for this program. In addition to the standard forms, applicants must provide a copy of the signed MOU with CMS to implement an approved Financial Alignment model. Applicants should review the application and submission information in the funding opportunity announcement for specific instructions on applying for this cooperative agreement program. Successful applicants will receive a Notice of Award (NoA) signed and dated by the Grants Management Officer. Contact the headquarters or regional office, as appropriate, for application deadlines. From 60 to 90 days. Not Applicable. Not Applicable. Applicant should refer to the funding opportunity announcement under this CFDA program for specific criteria requirements on proposal selection. This Funding Opportunity will provide financial assistance to State Health Insurance Assistance Programs (SHIPs) and/or Aging and Disability Resource Centers (ADRCs) to provide options counseling to Medicare-Medicaid Individuals (dual eligibles) to ensure that these individuals have access to an unbiased and consumer friendly source of information and counseling – distinct from the Demonstration Plans and Enrollment Brokers – to help them make informed decisions about options they have for receiving their Medicare and Medicaid benefits. Yes. Applicants should review the individual funding opportunity announcement for information on programmatic and evaluation reporting requirements. Yes. Submit a quarterly electronic Federal Financial Report (FFR) via the Payment Management System. The quarterly report identifies cash transactions against the authorized funds for the grant. The FFR Cash Transaction Reports must be filed within 30 days of the end of each quarter. Failure to submit the report may result in the inability to access grant funds. Go to - www.dpm.psc.gov for additional information. The final FFR, including both cash transactions and expenditures, must be submitted and received within 90 days of the end of the project period. Yes. Applicants should review the individual funding opportunity announcement for information on programmatic and evaluation reporting requirements. Yes. Grantees must include expenditures on the annual FFR (submitted at the end of each annual year). The final FFR must be submitted within 90 days after the end of the project period end date and include both cash transactions and expenditures data. No performance monitoring is required. In accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements, non-Federal entities that expend financial assistance of $750,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Non-Federal entities that expend less than $750,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503. Proper accounting records, identifiable by project number including all receipts and expenditures must be maintained for 3 years. Subsequent to audit, they must be maintained until all questions are resolved. This program has no statutory formula.
This program has no matching requirements.
This program does not have MOE requirements. This Cooperative Agreement is being funded for a period of performance of three (3) years, with support beyond the first year contingent upon acceptable evidence of satisfactory progress, and continuing program relevance. See the following for information on how assistance is awarded/released: Successful applicants will receive a Notice of Award. Unsuccessful applicants will be notified by letter. Applicants should review the award administration information of the funding opportunity announcement issued under this CFDA program for more information. See Regional Agency Offices. Christopher Clark, Office of Acquisition and Grants Management (OAGM), Centers for Medicare and Medicaid Services, 200 Independence Ave, SW, Room 733H-02, Washington DC 20201. Christopher Clark 200 Independence Ave., SW, Room 733H-02, Washington, District of Columbia 20201 Email: Christopher.Clark@cms.hhs.gov Phone: 301-492-4319 No Data Available 75-0522-0-1-551. (Project Grants) FY 14 $0; FY 15 est $3,311,460; and FY 16 est $4,688,540 The total estimated amount of Federal funds available is $5,000,000. Individual awards will range from $250,000 to $1,000,000. States with a signed Memorandum of Understanding (MOU) that receive awards under this funding opportunity will, per that MOU, be required to support options counseling. Following the initial deadline, based on available funding, applications will be accepted for review and approval throughout fiscal year 2013 according to the due dates outlined in the funding opportunity announcement. Applicants should refer to the funding opportunity announcement for applicable regulations, guidelines and literature. Not Applicable.