New York State Diabetes Prevention Program (NDPP)

The Department of Health announces the launch of the New York State Medicaid program´s coverage of the Centers for Disease Control and Prevention (CDC) National Diabetes Prevention Program (NDPP) for Medicaid members that meet established criteria for participation. The NDPP is an evidence–based, educational and support program designed to assist at–risk individuals from developing Type 2 diabetes.

To be eligible for enrollment in NYS Medicaid as an NDPP provider, Community Based Organizations (CBOs), Clinics, Practitioner Group Practices, or Sole Practitioner Group Practices must first achieve CDC–National Diabetes Prevention Recognition Program (DPRP) Pending, Preliminary, or Full recognition.

CBOs, Clinics, Practitioner Group Practices, or Sole Practitioner Group Practices that would like to offer, and be reimbursed by Medicaid for the NDPP lifestyle change program must first achieve NDPP–recognition from the CDC, based on the 2018 DPRP standards. To apply for CDC–recognition complete the online application at here.

Before applying for CDC–recognition, the applying organization or provider should review the DPRP Standards and Operating Procedures that describe the process of achieving, and maintaining CDC–NDPP recognition.  The DPRP standards are here.

The DPRP Standards also contains a capacity assessment. This is a list of questions designed to help an organization determine its readiness to deliver the CDC–recognized lifestyle change program. All organizations are strongly encouraged to complete this assessment, found here.

To view a registry of all of the CDC NDPP recognized organizations go here.

  • NYS NDPP allows for members to participate in 22 sessions over the course of one (1) year. This includes 16 weekly sessions that take place in the first 6 month, and six (6) monthly maintenance sessions that take place in the last six (6) months;
  • NYS NDPP allows for all CDC–DPRP (Pending, Preliminary, and Full) recognitions;
  • NYS NDPP does not limit NDPP services to once per lifetime;
  • NYS NDPP consists only of in–person, group training sessions;
    • The "Delivery Mode" referenced on the CDC–NDPP recognition letter awarding Pending, Preliminary, or Full recognition must reference a "Delivery Mode" of "In–Person".
  • NYS NDPP sessions are taught using a CDC approved curriculum by a trained Lifestyle Coach;
  • NYS NDPP sessions must be approximately one–hour in length;
  • The member´s body weight must be recorded at all sessions; and
  • Pursuant to the Medicaid approved SPA, NDPP services are provided as preventive services in accordance with 42 CFR Section 440.130(c), and services must be recommended by a physician or other licensed practitioner of the healing arts within his or her scope of practice.
  • The December 2019 Medicaid Update outlines steps and additional information and resources for providers who are interested in becoming a Medicaid–enrolled NDPP service provider.
  • In November 2019, Howard A. Zucker, M.D., J.D., NYS Commissioner of Health sent a letter to the state´s physicians highlighting the Department´s initiative to implement the CDC´s National Diabetes Prevention Program as a Medicaid–covered service in an effort to prevent or delay the onset of type 2 diabetes for Medicaid members. Read the letter here.
  • The November 2019 Medicaid Update presented additional information for providers interested in becoming a Medicaid-enrolled NDPP service provider. Medicaid NDPP service providers assist Medicaid members to make lasting behavior changes through group–based training and individual support.

CBOs, Clinics, Practitioner Group Practices, or Sole Practitioner Group Practices that have already achieved CDC–DPRP recognition to deliver NDPP services, and are looking to enroll in Medicaid as an NDPP provider need to:

  • Navigate to the NYS Medicaid eMedNY NDPP Provider Enrollment page, which is dedicated to the enrollment of CDC–recognized NDPP providers. Additional information pertaining to NDPP provider enrollment instructions, NDPP enrollment forms, and other important information about participating in the NYS Medicaid program as an NDPP provider is located here on the eMedNY NDPP Provider Enrollment page.

The eMedNY NDPP Listserv provides information relative to Medicaid´s coverage and reimbursement of the CDC´s NDPP for Medicaid FFS and MMC members.

How to Subscribe

Navigate to the "eMedNY Listserv" page, and scroll down to the National Diabetes Prevention Program (NDPP) on Listserv list, and click "Subscribe" to sign up for the NYS Medicaid NDPP Listserv.

Unsubscribe

Navigate to the "eMedNY Listserv" page, and scroll down to the National Diabetes Prevention Program (NDPP) on Listserv list, and click "Unsubscribe" to be removed from the NYS Medicaid NDPP Listserv.

Please contact the NDPP mailbox at NDPP@health.ny.gov for additional information, or for any questions pertaining to the NYS Medicaid NDPP.