Medicaid, HARP, and CHPlus (State-Sponsored Programs)

Medicaid National Diabetes Prevention Program (NDPP)

If your patients are at risk for developing type 2 diabetes, EmblemHealth covers services that may help.

As of Feb. 1, 2020, EmblemHealth covers diabetes prevention services through the National Diabetes Prevention Program (NDPP). This benefit covers 22 NDPP group training sessions over the course of 12 months.

 

The NDPP is an educational and support program designed to help prevent at-risk people from developing type 2 diabetes. The program consists of group training sessions that focus on the long-term, positive effects of healthy eating and exercise. The goals for these lifestyle changes include modest weight loss and increased physical activity. NDPP sessions are taught using a trained lifestyle coach.

 

Eligibility

Your patients may be eligible for diabetes prevention services if they have a recommendation by a physician or other licensed practitioner and are:

  • At least 18 years old,
  • Not currently pregnant,
  • Overweight, and
  • Have not been previously diagnosed with type 1 or type 2 diabetes.

And, they meet one of the following criteria:

  • They have had a blood test result in the prediabetes range within the past year, or
  • They have been previously diagnosed with gestational diabetes, or
  • They score 5 or higher on the CDC/American Diabetes Association (ADA) Prediabetes Risk Test.

For more information about NDPP, visit the Provider & Enrollment page here on the eMedNY website.

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