HHS – Affordable Care Act SHIP and ADRC Options Counseling for Medicare-Medicaid Individuals in States with Approved Financial Alignment Models

Applications Due: August 14, 2015, 11:59 p.m. Eastern Time

Description:  This Funding Opportunity will provide financial assistance to State Health Insurance Assistance Programs (SHIPs) and 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. SHIPs and ADRCs are directed to ensure that options counseling for Medicare-Medicaid individuals that are part of the State Demonstration is separate and distinct from benefits counseling they may perform for any and all beneficiaries that are not part of the State Demonstration described in this FOA and paid for under other grant funding opportunities.

Funding Title:    Affordable Care Act SHIP and ADRC Options Counseling for Medicare- Medicaid Individuals in States with Approved Financial Alignment Models

Agency Name:    Department of Health and Human Services, Centers for Medicare & Medicaid Services

Funding Instrument Type:     Cooperative Agreement

Express Language for Legal Aid:    No, however there is a specific mandatory provision for “options counseling”:

“This Funding Opportunity will provide financial assistance to SHIPs and/or 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 (See section 1.3 for definition) and Enrollment Brokers (See section I.3 for definition) – to help them make informed decisions about options they have for receiving their Medicare and Medicaid benefits. SHIPs and ADRCs are directed to ensure that options counseling for Medicare-Medicaid individuals that are part of the State Demonstration is separate and distinct from benefits counseling they may perform for any and all beneficiaries that are not part of the State Demonstration described in this FOA and paid for under other grant funding opportunities.” …

“A state signing the MOU, will, per that MOU, be required to support options counseling.”

Target Population:    Medicare-Medicaid individuals (duel eligibles)

Expected Number of Awards:

Cost Sharing or Matching Requirement:    No

How to Apply:  Applications must be submitted through www.grants.gov

Current Closing Date for Applications:    August 14, 2015, 11:59 p.m. Eastern Time

Estimated Total Program Funding:    $8,000,000

Award Ceiling:    $1,000,000

Award Floor:    $0

Eligible Applicants:   Certain state governments. Eligible applicants from the CMS-approved Financial Alignment States include any one of the state agencies that administers the ADRC and/or SHIP program(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). Regardless of which agency serves as the “lead” applicant agency, the State Unit on Aging, State Department of Insurance, State Disability Agency/Agencies and State Medicaid Agency must all be involved in the planning, development and implementation of the state’s options counseling efforts under this funding opportunity.

Priority Consideration:   

Policy and Regulations on Use of Funds:   See Amended Announcement  

Current/Past Funding Recipients:

Samples of Successful Application:

Link to Full Information: Amended Announcement

Contact Information:

1. For programmatic questions about this Cooperative Agreement to please contact:

Latonya Phipps
U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services 7500 Security Blvd.
Mail Stop: S3-13-23

Baltimore, MD 21244

Telephone: (410) 786-8045
E-mail: Latonya.Phipps@cms.hhs.gov

2. Administrative Questions

For administrative questions about this Cooperative Agreement please contact:

Christopher Clark
U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services 7501 Wisconsin Avenue
Bethesda, MD 20814
Attn: Christopher Clark
Telephone (301) 492-4319
e-mail: Christopher.Clark@cms.hhs.gov

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Categories: Affordable Care Act, Consumer, Government Organizations, Health Care, Medicaid, Medicare, Pass-Through Funds/ Block Grants

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