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Elizabeth M. Whitehorn, Director

Provider Notice issued 11/04/2024

 

To: All Medical Assistance Program Providers
​Date November 4, 2024
​Re:
 Increase in Age Limit for Diabetes Prevention and Management Programs Effective November 1, 2024 

This notice informs diabetes prevention and management programs that the Department of Healthcare and Family Services (HFS) is increasing the upper age limit for customers to receive these services. This applies to the Medicaid fee-for-service (FFS) program and the managed care organizations (MCOs).

HFS has previously notified providers of coverage for these programs via provider notices dated August 5, 2024, July 29, 2022, and August 20, 2021. The age range for diabetes prevention and management programs was originally set at 18 through 64 years. To expand coverage to customers 65 and over who do not qualify for Medicare and cannot receive these services through that program, HFS is eliminating the upper age limit effective November 1, 2024. The Billing Guidelines for Diabetes Prevention and Management Programs document has been updated to reflect the new age range.

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for the FFS program, or the applicable MCO.

 

Kelly Cunningham, Administrator
Division of Medical Programs