Support for Beneficiary Counseling Programs for States Participating in the Medicare- Medicaid Financial Alignment Initiative | Apply Online

Opportunity Summary:

The grant opportunity titled "Support for Beneficiary Counseling Programs for States Participating in the Medicare-Medicaid Financial Alignment Initiative" (Funding Opportunity Number CMS-1J1-17-001) is a discretionary cooperative agreement offered by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS), under the Affordable Care Act funding activity category (CFDA 93.634). Its overall goal is to strengthen beneficiary help systems for people who are eligible for demonstrations under the Medicare-Medicaid Financial Alignment Initiative, a set of state demonstrations designed to better coordinate care and financing for individuals enrolled in both Medicare and Medicaid (often referred to as "dual eligible" beneficiaries). In practical terms, the funding is aimed at making sure beneficiaries have reliable, independent support to understand their coverage choices, navigate enrollment and benefits, and resolve problems that arise while participating in these demonstrations.

The announcement funds two main types of beneficiary support activities. First, it offers continued support for Ombudsman services by providing an additional two years of funding for existing Demonstration Ombudsman Programs. This portion of the funding is narrowly targeted: only states that were already receiving CMS funding for Demonstration Ombudsman Programs under the earlier grant number CMS-1J1-13-001 are eligible to apply for this ombudsman-services funding. The eligible states explicitly listed are California, Colorado, Illinois, Massachusetts, Michigan, Ohio, Rhode Island, and South Carolina. The intent behind this stream is to sustain and extend established ombudsman capacity in states that already built these programs, recognizing that beneficiaries in alignment demonstrations often need an independent entity that can assist with complaints, appeals, access-to-care issues, and other complex problems that can arise when Medicare and Medicaid services are being integrated.

Second, the opportunity supports one-on-one counseling activities, which are designed to give beneficiaries individualized information and options counseling about health coverage choices. This can include helping people understand what the demonstration means for them, what choices they may have, how to use benefits, and how to compare options when decisions are required. A major shift in this announcement is increased flexibility about who can run the one-on-one counseling program. Previously, funding for this function was limited to arrangements where the State Health Insurance Information Assistance Program (SHIP) and the Aging and Disability Resource Center (ADRC) worked together to provide the service. Under this announcement, states are allowed to decide what entity will provide one-on-one counseling and how the program will be structured. CMS notes that the state-selected entity could be a SHIP, an ADRC, a joint SHIP-ADRC effort, an ombudsman program, or another appropriate entity chosen by the state. This flexibility is meant to let states build a counseling model that fits their existing infrastructure and beneficiary needs, rather than forcing a single prescribed organizational setup.

Only state governments are eligible applicants, consistent with the fact that the demonstrations and related beneficiary supports are state-based and tied to state participation in the Financial Alignment Initiative. The cooperative agreement structure indicates that CMS expects to have an ongoing role beyond simply issuing funds, typically through collaboration, oversight, and technical guidance during implementation. The notice lists an award ceiling of $3,000,000 and anticipates up to 20 awards, suggesting that multiple states or state-led efforts could be supported, with award sizes potentially varying depending on the scope of the counseling and ombudsman activities being proposed and the size and needs of the beneficiary population served.

The opportunity was created on September 30, 2016, and it used multiple submission rounds rather than a single deadline. The original closing date was November 1, 2016 (first round), followed by additional rounds on January 9, 2017 (second round), June 1, 2017 (third round), September 5, 2017 (fourth round), and May 1, 2018 (fifth round), with the listed submission time of 3:00 p.m. Eastern Standard Time. Overall, the grant is best understood as a CMS effort to maintain and strengthen beneficiary-facing assistance systems in Financial Alignment Initiative states, combining continued support for established ombudsman programs in a defined set of states with a more flexible pathway for states to deliver individualized counseling through entities that make the most sense locally.

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