National DPP Coverage Toolkit: State Plan Amendment Update

NACDD, in collaboration with Leavitt Partners, continues to make updates to the National DPP Coverage Toolkit (Coverage Toolkit) to enhance content and improve user experience. One of the latest updates is to the State Plan Amendment page under Medicaid Coverage.

A Medicaid State Plan is a written agreement between a state and the federal government outlining the details of the state’s Medicaid program, including benefits, provider rates, and eligibility for coverage. A State Plan Amendment (SPA) may be necessary to add covered services to a state’s Medicaid program that would encompass the National Diabetes Prevention Program (National DPP) lifestyle change program. It also may be used to allow non-licensed lifestyle coaches, such as community health workers (CHWs), to be reimbursed by Medicaid.

One of the most common questions we get from states considering a SPA for coverage of the National DPP lifestyle change program is “What have other states put in their SPAs to provide this benefit?” To address these questions more fully, the Coverage Toolkit now contains several state examples, including Minnesota, Montana, and New Jersey. Providing reimbursement to CHWs to deliver the National DPP lifestyle change program is another common consideration by states; information on this pathway to coverage is now included in this section of the Coverage Toolkit as well. For more information, contract Joanna DiBennedetto at