ACA Support for Demonstration Ombudsman Programs Serving Beneficiaries of State Demonstrations to Integrate Care for Medicare-Medicaid


CMS is presenting this Funding Opportunity Announcement (FOA) to ensure that the beneficiaries of the Financial Alignment Demonstration models – as well as their caregivers and authorized representatives -- have access to person-centered assistance in resolving problems related to the Plans and providers.

General information about this opportunity
Last Known Status
Program Number
Federal Agency/Office
Agency: Department of Health and Human Services
Office: Centers for Medicare and Medicaid Services
Type(s) of Assistance Offered
Cooperative Agreements
Program Accomplishments
Not Applicable.
Statutory Authority: section 1115A of the Social Security Act (added by section 3021 of the Patient Protection and Affordable Care Act (P.L. 111-148).
Who is eligible to apply/benefit from this assistance?
Applicant Eligibility
States which have signed an MOU with CMS to implement one of the financial alignment demonstration models.
Beneficiary Eligibility
States which have signed an MOU with CMS to implement one of the financial alignment demonstration models.

Enrollees and caregivers in the Financial Alignment Demonstration,.
A state must be pursuing a financial alignment model. 2 CFR 200, Subpart E - Cost Principles applies to this program.
What is the process for applying and being award this assistance?
Pre-Application Procedure
Preapplication coordination is not applicable. Environmental impact information is not required for this program. This program is excluded from coverage under E.O. 12372.
Application Procedure
2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program.
Award Procedure
Awards will be made to state agencies to implement ombudsman programs to support the Financial Alignment Demonstration. States may choose to contract with other parties to implement their program.
Aug 07, 2013: Applications will be due 45 days after posting. Release date:

Applications are due on the following dates:
1st Round: August 5, 2013, 3:00 PM EST
2nd Round: October 3, 2013
3rd Round: January 14,2014

Applications will be due 45 days after posting.
Approval/Disapproval Decision Time
45 to 60 days.
Not Applicable.
Not Applicable.
How are proposals selected?
Applications will be scored with a total of 100 points available. The following criteria will be used to evaluate applications received in response to this solicitation. More information about each criteria can be found in the funding opportunity announcement.

Proposed Approach (30 Points)
Organizational Capacity and Management Plan (25 Points)
Evaluation and Reporting (20 Points)
Budget and Budget Narrative (25 Points).
How may assistance be used?
Through this cooperative agreement, CMS seeks to fund activities necessary to plan for, develop and implement Demonstration Ombudsman Program services to beneficiaries and their families, as appropriate. Restrictions: Direct services already provided by Medicare or Medicaid.
What are the requirements after being awarded this opportunity?
Semi-Annual and data reports. Quarterly reporting will be required. Semi-Annual progress reports will be required. Quarterly expenditure reports will be required. Performance monitoring is not applicable.
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.
Accounting and Programmatic records must be maintained for three years.
Other Assistance Considerations
Formula and Matching Requirements
This program has no statutory formula.
This program has no matching requirements.
This program does not have MOE requirements.
Length and Time Phasing of Assistance
Yes, 3 years. Method of awarding/releasing assistance: quarterly.
Who do I contact about this opportunity?
Regional or Local Office
Headquarters Office
Kemuel Johnson 7500 Security Boulevard
Baltimore, MD 21207, Baltimore, Maryland 21207 Email: Phone: 4107868200
Website Address
Financial Information
Account Identification
(Cooperative Agreements) FY 14 $2,504,118; FY 15 est $4,374,987; and FY 16 est $3,470,956
Range and Average of Financial Assistance
Regulations, Guidelines and Literature
Not Applicable.
Examples of Funded Projects
Not Applicable.


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