TopAt a Glance
January 31, 2020                                                                                  
In This Issue
In December 2019, there were 1,207,566 Coloradans enrolled in Health First Colorado and 75,277 enrolled in
Upcoming Events and Helpful Resources
Health First Colorado printed materials are available on our website
Health First Colorado videos for use in waiting rooms and other areas members visit are available for download 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 webpage. 

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 & Financing jobs.
Welcome to the January 2020 edition of At a Glance!

At a Glance is a Department of Health Care Policy & Financing (Department) 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!

A Message from the Executive Director
Stakeholders and Partners:
In early January, the Department had the opportunity to  present  our   performance plan  and provide updates on our goals to the Health Committees in the House and Senate.  We have made significant progress together in improving the lives of the Coloradans we serve.  A few examples include, reducing opioid use, reducing call wait times in our provider and member call centers, improving access to care by increasing the number of enrolled providers serving our members, increasing usage the PEAK mobile app, improving our analytic systems so that we can identify the members who need the most support, and creating pathways for our Regional Accountable Entities partners to better respond to those needs.
We are excited to continue to make progress on the strategic focus areas outlined below.
  • Member Health 
  • Customer Service 
  • Operational Excellence 
  • Medicaid Cost Control 
  • Health Care Affordability for Coloradans 
The Department's  budget  and  legislative  agendas will continue to move this important work forward.  For more information visit our legislative resource center online.  

Kim Bimestefer
Breaking News
Colorado Hospital Cost Shift Analysis Report
Colorado is proud to be one of the healthiest states in the country, but despite this achievement, Coloradans face some of the highest health care costs.

The Department and Lt. Governor Dianne Primavera released the  Colorado Hospital Cost Shift Analysis Report that reveals, despite significant reductions in uninsured rates and uncompensated care, Colorado hospitals are persistently increasing the price of care while receiving significant increases in Medicaid payment rates.

For more information, read the report and the news release.
Denver Health Medicaid Choice Contract Change
The Department has  revised its contract arrangement for members enrolled in Denver Health Medicaid Choice. Under this new contract, Denver Health is partnering with Colorado Access to manage behavioral health services for its members. 

This contracting change alters how Denver Health Medicaid Choice members appear in the Provider Web Portal. Denver Health Medical Plan is now listed in the Regional Accountable Entity field.  

There is no change to how providers deliver, authorize, or process reimbursement for services to members enrolled in Denver Health Medicaid Choice.  
  • Denver Health still administers and reimburses all covered physical health services. (Contact Denver Health Medicaid Choice at 303-602-2116 with questions.) 
  • Col orado Access still administers and reimburses all covered behavioral health services. (Contact Colorado Access at 303-368-0038 or 855-384-7926 with questions.) 
For more information and frequently asked questions, read the fact sheet. 
Difficulty of Care Payments
The Department has posted an operational memo to communicate how Difficulty of Care payments are calculated for an individual's income eligibility for Health First Colorado (Colorado's Medicaid Program) and Child Health Plan Plus (CHP+) MAGI and Non-MAGI based eligibility categories. 
For more information, read the operational memo: Difficulty of Care payments.
Cost of Living Adjustments
The Department has posted an operational memo to  advise eligibility sites of the 2020 Social Security Cost of Living Adjustments (COLA). 

The purpose of the COLA is to ensure that the purchasing power of Social Security and Supplemental Security Income (SSI) benefits is not eroded by inflation. 
For more information, read the operational memo: 2020 Social Security Cost of Living Adjustments.
Increase to Resource Limits
The Department has posted an operational memo to  advise eligibility sites of the increased resource limits for Qualified Medicare Beneficiaries (QMB), Specified Low-income Medicare Beneficiaries (SLMB), Qualified Individuals (QI-1), and Low-income Subsidy (LIS) resource limits.  The resource test was increased effective January 1, 2020, for QMB, SLMB, QI-1, and LIS.
For more information, read the operational memo: 2020 Increase to Resource Limits: Medicare Savings Program and Low-income Subsidy.
Tools for Transformation
Hospital Transformation Program Update
Update on federal authorities
On December 31, 2019, the Department submitted both the Hospital Transformation Program (HTP) 1115 demonstration waiver application and the State Plan Amendment (SPA) to the Centers for Medicare and Medicaid Services (CMS). This is a big milestone for HTP and we'd like to thank stakeholders, hospitals and community partners for their participation in the process. The next steps in the process involve a 30-day federal comment period as well as the Department working with CMS to address any questions that arise during this period. The waiver is currently posted for federal public comment on the  CMS website .
HTP Road Show training for hospitals
The HTP team will be traveling around the state for in-person trainings to review the requirements and answer questions for hospitals participating in the HTP. Please see the  attached flyer  and with the dates and locations of these trainings.  Additional details will be forthcoming in future HTP Newsletters.
Community Advisory Council
The Community Advisory Council continues to meet monthly. Notes and agendas from December meeting can be found on the  Community Advisory Council website We'd like to thank council members for their thoughtful feedback and recommendations since the group was formed in September 2019. Questions about the council should be directed to the Community Advisory Council  email box .

If you'd like to know more about the HTP, we encourage you to visit the HTP website as well as read past editions of the HTP Newsletter in our online archives.

For more information, contact Courtney Ronner.
Delivery System Innovation
Substance Use Disorder Benefit Update
Section 1115 Substance Use Disorder (SUD) Waiver Demonstration Application
The Department is engaged with the Centers for Medicare and Medicaid Services (CMS) in discussion about the content of the State's proposed Section 1115 Substance Use Disorder (SUD) waiver demonstration application. The Department is also in the process of amending the Colorado State Plan to include residential and inpatient SUD treatment and withdrawal management services. Tribal notice for the State Plan modifications concluded on January 15, 2020. The Department will submit the draft amendments during January. 

Regional Capacity Stakeholder Meetings 
The Department continues its series of Regional Capacity Meetings during January and February 2020. At these public meetings, the Department will be presenting information on SUD treatment capacity and hearing from community members about the needs in that local area. The regional meetings serve as opportunities for the public to provide input and ask questions about the implementation of coverage for residential and inpatient SUD treatment and withdrawal management services. 

SUD Implementation Workgroup
The Department convened the SUD Implementation Workgroup on January 15, 2020. The Implementation Workgroup, comprised of representatives from Regional Accountable Entities (RAEs), Managed Services Organizations (MSOs), Colorado Office of Behavioral Health, and Department staff, will address various issues (utilization management, care coordination, provider enrollment/billing, capacity development, provider training and support, etc.) that need to be addressed prior to the introduction in July 2020 of Medicaid coverage for new SUD treatment benefits.
For more information, please visit the Department's SUD website . 
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Nondiscrimination Policy
The Colorado Department of Health Care Policy & 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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