Funding to Support Ombudsman Programs
09/30/16 - Updated funding opportunity announcement (FOA) information.
On September 30, 2016, CMS released a funding opportunity announcement (FOA) to support demonstration ombudsman programs and one-on-one counseling services in states participating in the Medicare-Medicaid Financial Alignment Initiative. This announcement will provide eligible states with an additional two years of funding for these two separate-but-related beneficiary support programs:
- Ombudsman programs provide beneficiaries with person-centered assistance to resolve problems. Ombudsman programs also inform states, plans, CMS, and other stakeholders regarding trends and identify areas for improvement within the demonstrations.
- One-on-one counseling programs, such as State Health Insurance Assistance Programs (SHIPs) and Aging and Disability Resource Centers (ADRCs), conduct outreach and provide education and assistance to beneficiaries regarding their insurance options.
This FOA is a continuation of the support for both ombudsman and one-on-one counseling programs that has been part of the Financial Alignment Initiative since its inception to ensure robust beneficiary supports in all demonstrations.
The FOA can be accessed by using the following link: http://www.grants.gov/web/grants/search-grants.html and search for CFDA 93.634.
Information for Beneficiaries
Each demonstration includes an "Ombudsman Program" to help people solve problems related to their services. You may search for your state's ombudsman program below:
Demonstration: Cal MediConnect
Ombudsman: Health Consumer Alliance
Demonstration: Accountable Care Collaborative (ACC)
Ombudsman: Medicare/Medicaid Advocate https://disabilitylawco.org/
Demonstration: Medicare-Medicaid Alignment Initiative (MMAI)
Medicare-Medicaid Alignment Initiative (MMAI) Ombudsman https://www.illinois.gov/aging/ProtectionAdvocacy/LTCOmbudsmen/Pages/default.aspx
Demonstration: One Care
One Care Ombudsman
Demonstration: MI Health Link
MI Health Link Ombudsman
Demonstration: New York Fully Integrated Duals Advantage (FIDA) Demonstration
Ombudsman: Independent Consumer Advocacy Network (ICAN)
Demonstration: MyCare Ohio
MyCare Ohio Ombudsman
Demonstration: Integrated Care Initiative
Integrated Care Initiative Ombudsman Program
Demonstration: Healthy Connections Prime
Healthy Connections Prime Ombudsman Program
Demonstration: Texas Dual Eligible Integrated Care Project
Health and Human Services Commission (HHSC) Office of the Ombudsman
Demonstration: Commonwealth Coordinated Care (CCC)
Commonwealth Coordinated Care (CCC) Ombudsman
Demonstration: HealthPath Washington
Ombudsman Program Washington State Department of Social and Health Services
On June 27, 2013 the Department of Health and Human Services released a Funding Opportunity Announcement through which states can apply for funding to develop independent Ombudsman Programs to support demonstrations through the Financial Alignment Initiative.
- Press Release
- Fact Sheet
- Announcement in the Catalog of Federal Domestic Assistance
- Funding Opportunity Announcement
- Frequently Asked Questions
Previous Awards Made
All Ombudsman awards are made for twelve month periods. Amounts awarded to date are below.
- California - $3,000,000 (Year 1, $708,366; Year 2, $1,145,817; Year 3, $1,145,817) (September 2013 date of first award)
- Colorado - $442,645 (Year 1, $210,760; Year 2, $231,885; Year 3, $231,885) (September 2014 date of first award)
- Illinois - $1,398,678 (Year 1, $267,556; Year 2, $565,561; Year 3, $565,561) (December 2013 date of first award)
- Massachusetts - $554,675 (Year 1, $159,084; Year 2, $395,591) (May 2014 date of first award)
- Michigan - $303,667 (March 2015 date of first award)
- Ohio - $723,224 (Year 1, $272,354; Year 2, $479,927; Year 3, $479,927) (March 2014 date of first award)
- Rhode Island - $165,623 (September 2015 date of first award)
- South Carolina - $246,493 (September 2015 date of first award)
- Virginia - $924,237 (Year 1, $245,079; Year 2, $339,579; Year 3, $339,579) (November 2013 date of first award)
- Washington - $203,468 (May 2014 date of first award)
Ombudsman Technical Assistance Program
The Administration for Community Living (ACL) operates the Office of Dual Demonstration Ombudsman Technical Assistance Program to support CMS state grantees that are designing and implementing an ombudsman program to support the implementation of their financial alignment model.
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