ACA Support for Ombudsman and Beneficiary Counseling Programs for States Participating in the Medicare-Medicaid Financial Alignment Initiative

CMS is presenting this Funding Opportunity Announcement (FOA) to ensure that the beneficiaries of the Financial Alignment Demonstration models ? as well as their caregivers and authorized representatives -- have access to person-centered assistance in resolving problems and selecting appropriate health
care coverage related to the Plans and providers.

Agency - Department of Health and Human Services

The Department of Health and Human Services is the Federal government's principal agency for protecting the health of all Americans and providing essential human services, especially to those who are least able to help themselves.

Program Accomplishments

Not Applicable.

Uses and Use Restrictions

Through this cooperative agreement, CMS seeks to fund activities necessary to plan for, develop and implement Demonstration Ombudsman Program services and beneficiary counseling to beneficiaries and their families, as appropriate.

Restrictions: Direct services already provided by Medicare or Medicaid.

Restrictions: Direct services already provided by Medicare or Medicaid.

Eligibility Requirements

Applicant Eligibility

States which have signed an MOU with CMS to implement one of the financial alignment demonstration models.

Beneficiary Eligibility

States which have signed an MOU with CMS to implement one of the financial alignment demonstration models. Enrollees and caregivers in the Financial Alignment Demonstration,.


A state must be pursuing a financial alignment model. 2 CFR 200, Subpart E - Cost Principles applies to this program.

Aplication and Award Process

Preapplication Coordination

Preapplication coordination is not applicable.

Environmental impact information is not required for this program.

This program is excluded from coverage under E.O.


Application Procedures

2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards applies to this program.

Award Procedures

Awards will be made to state agencies to implement ombudsman and counseling programs to support the Financial Alignment Demonstration.


Nov 01, 2016 to Sep 30, 2016: Applications will be due 45 days after posting. Applications are due on the following dates: 1st Round: November 1, 2016, 3:00 PM EST 2nd Round: January 9, 2017 3rd Round: June 1, 2017 Fourth Round: September 5, 2017 Fifth Round: May 1, 2018.


Statutory Authority: section 1115A of the Social Security Act (added by section 3021 of the Patient Protection and Affordable Care Act (P.L. 111-148).

Range of Approval/Disapproval Time

45 to 60 days.


Not Applicable.


Not Applicable.

Assistance Considerations

Formula and Matching Requirements

This program has no statutory formula. This program has no matching requirements. This program does not have MOE requirements.

Length and Time Phasing of Assistance

Yes, 2 years. Method of awarding/releasing assistance: quarterly.

Post Assistance Requirements


Monthly and quarterly data reports.

Quarterly reporting will be required.

Semi-Annual progress reports will be required.

Quarterly expenditure reports will be required.

Performance monitoring is not applicable.


In accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements, non-Federal entities that expend financial assistance of $750,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Non-Federal entities that expend less than $750,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503.


Accounting and Programmatic records must be maintained for three years.

Financial Information

Account Identification



(Cooperative Agreements) FY 17 $6,136,831; FY 18 est $7,449,731; and FY 19 Estimate Not Available

Range and Average of Financial Assistance

Awards range from $149,000-$$1,494,476 per year.

Regulations, Guidelines, and Literature

Not Applicable.

Information Contacts

Regional or Local Office


Headquarters Office

Kemuel Johnson 7500 Security Boulevard Baltimore, MD 21207, Baltimore, Maryland 21207 Email: Phone: 4107868200

Criteria for Selecting Proposals

Applications will be scored with a total of 100 points if only applying for one program and 200 points if applying for both ombudsman and counseling funding.

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