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2020-21 MIPPA Grant Agency Application F-02388 (09/2020)

2020-21 Medicare Improvements for Patients and Providers Act (MIPPA) Grant Agency Application

1. My agency is interested in receiving MIPPA grant funding from the Wisconsin Department of Health Services (DHS) for the project period that extends from September 1, 2020, to August 31, 2021. (Select one answer.) *This question is required.
My agency meets both of the following grant funding requirements. (Select all that apply.) *This question is required.
If awarded 2020 MIPPA grant funding, my agency would like to participate in the following activities related to the Medicare Savings Programs (MSP), Medicare Part D extra help (LIS), and Medicare preventive benefits. (Select all that apply.) *This question is required.