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TopAt a Glance
August 31, 2017                                                                                      
In This Issue
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In July 2017 there were 1,360,760 Coloradans enrolled in Health First Colorado (Colorado's Medicaid Program) and 75,254 enrolled in Child Health Plan Plus (CHP+).
Upcoming Events and Helpful Resources
Health First Colorado printed materials are available on our website
New to PEAK or Need a Refresher?

The Intro to PEAK and Application Walk-Through recorded webinars are available anytime. For more information and trainings, visit the PEAK Outreach Initiative website.
Public Rule Review Opportunities

Anyone interested in a one-on-one discussion with Department staff about upcoming rules is invited to attend the Department's Public Rule Review Meeting. Information is available on the Public Rule Review Meetings web page. 

For more information, or to be added to the Medical Services Board email distribution list, please contact Chris Sykes.
Employment Opportunities

Applying for state government jobs is easy. Applications are electronic, you will receive updates, and you do not need to answer any written questions until it is determined that you meet the minimum qualifications. 

Check out the website for State of Colorado jobs including the Department of Health Care Policy and Financing jobs.
Welcome to the August 2017 edition of At a Glance!

At a Glance is a Department of Health Care Policy and Financing publication which provides information on major initiatives including policy changes and program updates. Please feel free to share At a Glance with your colleagues. Previous editions of At a Glance are available on our website.

Thank you for your interest!


Breaking News

Future of Child Health Plan Plus Update
Unless Congress acts, federal funding for the Children's Health Insurance Program (known as Child Health Plan Plus, or CHP+, in Colorado) ends September 30, 2017. 

At this time, there are no changes to CHP+ eligibility or the CHP+ program, however, the Department is beginning to plan for the necessary actions that will need to be taken if Congress does not continue funding.
Current law allows states to spend unspent federal dollars collected before October 1, 2017. The Department estimates that Colorado can use these funds for health care for CHP+ members until sometime in the first quarter of calendar year 2018. For more information, please visit
In the event that CHP+ materials you produce may need to be updated as new information is available, please flag brochures, web pages, letters to members, and any other electronic or print materials that you create or disseminate that reference the CHP+ program. No other action is needed at this time. This inventory will be vital if CHP+ changes warrant any editing or discontinuation of these electronic or print materials.
If you have questions about the CHP+ program please send them to
The Children's Health Insurance Program: The Path Forward
Senate Finance Committee Chairman Orrin Hatch (R-Utah) and Ranking Member Ron Wyden (D-Ore.) will convene a hearing to discuss the Children's Health Insurance Program (CHIP). 

The Children's Health Insurance Program: The Path Forward, will take place Thursday, Sept. 7, 2017, at 8:00 a.m. MDT.

For more information, visit the Committee's website.
Building Better Health Conference Coming in September

Building Better Health Conference
September 25-26, 2017
Hyatt Regency Aurora-Denver Convention Center
13200 E 14th Place
Aurora, CO 80011
The Building Better Health Conference is the only in-person training and networking opportunity for Colorado's assisters, brokers, community based organizations and advocates.
This statewide health coverage open enrollment kick-off and training event is hosted by Colorado Covering Kids and Families with the Colorado Department of Health Care Policy and Financing, the Colorado Division of Insurance, Connect for Health Colorado, the Colorado Consumer Health Initiative and PEAK Outreach. 

PEAK Customer Survey Deadline Extended
The new survey deadline will be 11:59 p.m. on Friday, Sept. 15.

Dear Eligibility & Enrollment Colleagues,
The State of Colorado is gathering customer feedback on the usability of the Program Eligibility and Application Kit, better known as PEAK. We are requesting your assistance in sharing an online survey with PEAK customers that will inform future system improvements and measure year-over-year progress. We ask that if you assist customers with using PEAK, please refrain from completing this survey.
Below is the suggested email copy we encourage you to send to your customer distribution lists. Feel free to add the survey link to newsletters, bulletins, etc.

Calling all Colorado PEAK users...
The State of Colorado wants to hear from you! If you have used PEAK, we invite you to take a short survey to tell us your thoughts. is the fast and easy way to complete an application and manage your benefits online. By getting helpful feedback from customers like you, we can continue to improve the website used by thousands of Coloradans each month.
Thank you in advance for helping us make improvements to PEAK based on direct customer feedback!

For more information, contact Brandi Simmons.
Provider Letters for Pharmacy Prior Authorization Request Approval and Denial 
Providers will no longer receive a copy of the pharmacy Prior Authorization Request (PAR) approval or denial letters that are sent to members. Providers already receive notice of the approval or denial via telephone and/or fax before the copy of the member letter is sent to the provider. All other processes of receiving approval or denials will remain the same. Below is a reiteration of the process:
Pharmacy PARs by fax:
When a provider faxes a request, no later than 24 hours after the request is made, the provider will receive an approval or denial via fax.
  • If the PAR is incomplete or additional information is needed, a request for additional information shall be initiated within one working day from the day the request was received.
  • If the provider does not respond within 24 hours of the Department's request for additional information, the PAR shall be denied.  
Pharmacy PARs by phone:
When a provider calls to request a prior authorization, the provider will receive a verbal approval, denial or request for more information while on the phone.  The provider will receive a follow up fax with the same information.
Training resources for interChange are still available for all providers
As providers continue to learn more about Colorado's new interChange system, resources are still available for learning the basics of the portal, including information on eligibility verification, reading and understanding remittance advice and managing accounts including delegates. 

Providers can use system webinarsbilling manuals and  quick guides to understand common problems and changes in the new system which may be unfamiliar.

Webinar resources were recorded during the launch of the system, and are still relevant to issues providers are dealing with daily. Visit this site to select your topic of interest. Once your topic is selected, you'll be asked to register and will then be taken directly to the webinar on your topic.
Tools for Transformation
Last Chance to Apply for TCPi
Sign-up before September 29, 2017 for the Transforming Clinical Practice Initiative (TCPi), which helps healthcare providers succeed with alternative payment models through valuable coaching and guidance to capitalize on valuable, customized coaching support that is valued at $20,000. 

There are more than 1,600 physicians participating in the initiative, which can support 2,000 providers in the state. Learn more and apply today  before time runs out.

Partnerships to Improve Population Health
Videos Now Available for Download!
Thank you for helping us communicate these important messages to Health First Colorado members! 

Delivery Systems Innovation
No Wrong Door Pilot Sites Launch
In September 2015, Colorado secured a three-year implementation grant from the federal Administration on Community Living to develop a model for implementing a No Wrong Door system statewide. 

A No Wrong Door system provides a seamless entry point system for all individuals seeking long-term services and supports, regardless of age, disability or pay source. The objective is that the system also address many of the major challenges currently experienced by individuals seeking long-term services and supports. 

In March 2017, four proposals were selected to serve as regional pilot sites over a two-year period. The pilot sites will test and refine various tools and approaches to carry out the functions of a No Wrong Door system as articulated by the federal Administration on Community Living. 

The pilot sites launched in summer 2017 and will help Colorado determine how to create a single No Wrong Door system model to be implemented statewide, following the end of the pilot period. 

New Substance Use Disorder Training Available
Health care providers are encouraged to take advantage of a new substance use disorder (SUD) e-learning module that was released last week. 

This module, which was funded by the Colorado State Innovation Model (SIM), gives care teams comprehensive and practical information about how to integrate and maximize behavioral health in primary care practices. 

Help Reform Health Care in Colorado
Want to help reform healthcare in Colorado in meaningful, sustainable ways? 

Join the Colorado State Innovation Model (SIM), an entrepreneurial team that is helping providers integrate behavioral and physical health in primary care settings.

Accountable Care Collaborative Enrollment Update
As of August 2017, 1,062,494 Health First Colorado members were enrolled in the Accountable Care Collaborative. This number includes 38,053 who are members of the Accountable Care Collaborative Rocky PRIME program on Colorado's western slope.
Approximately 770,400 Accountable Care Collaborative members are attributed to a medical home.

Operational Excellence
Whole Person Care Improves Outcomes
The Colorado State Innovation Model (SIM) is working with four community mental health centers (CMHCs) during the initiative's four-year time frame to integrate physical health into mental health settings. In addition, SIM will help 400 primary care practice sites integrate behavioral and physical health. 

The ability to deliver this type of "whole-person care" has been shown to improve patient outcomes. Learn more about the CMHCs and the innovative work underway in the SIM podcast series.

Nondiscrimination Policy
The Colorado Department of Health Care Policy and Financing complies with applicable federal and state civil rights laws and does not discriminate on the basis of race, color, ethnic or national origin, ancestry, age, sex, gender, sexual orientation, gender identity and expression, religion, creed, political beliefs, or disability. Learn more about our Nondiscrimination Policy.

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