TopAt a Glance
July 31, 2020                                                                                  
In This Issue
In June 2020, there were 1,277,431 Coloradans enrolled in Health First Colorado and 77,233 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 July 2020 edition of At a Glance!

At a Glance is a Department of Health Care Policy & Financing (Department) publication that provides information on major initiatives, 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
This year's unusual legislative session has come to an end, including the Governor's signature on the Long Bill, which sets the State's budget. I want to thank you for your partnership in adopting the difficult but necessary cuts to the Department's budget during this unprecedented economic downturn. The impact of COVID-19 is causing an increase in demand for our safety net programs and a concurrent decrease in available state funds -- certainly a difficult reality to navigate. Cuts to the Department budget impacted member co-pays, provider reimbursement, some benefits and Department administration funding, as well.
Our members will see an increase in co-pays to the federal maximum on pharmacy, physician services, Federally Qualified Health Center visits, Regional Health Center visits, inpatient services, outpatient services, durable medical equipment, lab and x-ray, anesthesia, Non-Emergent Medical Transportation (NEMT) and dental services. Members currently exempt from co-pays will continue to be exempt from co-pays. At the same time,  House Bill 20-1361 reduces the cap for the adult dental benefit from $1,500 to $1,000 per year for each recipient until December 2022. Both changes will be effective upon federal approval, but not before January 2021.

In addition, providers will see many changes resulting from budget considerations this legislative session. You can read our  2020-2021 HCPF Long Bill Overview and  2020 HCPF Legislative Session Wrap-Up for more details. We will communicate additional information on each item in coming months as changes are implemented.

Coloradans need our programs now more than ever, including the support and services you provide every day through your work and partnership with us. The Department anticipates a net membership surge of 300,000 to 500,000 Coloradans as the downturn causes Coloradans to lose their jobs and their associated employer-sponsored health coverage -- figures that could exceed the membership uptake fueled by the Accountable Care Act.

We also want to thank you for your partnership in communicating our Here For YOU, Colorado! campaign, which is intended to help keep Coloradans covered during this pandemic and economic downturn. Resources we created last quarter to provide easy-to-use materials for your own outreach campaign. Key messages cover Health First Colorado (Colorado's Medicaid program) and Child Health Plan Plus (CHP+) eligibility rules, benefits, how to apply, provider enrollment and more. Please help us spread the word! Visit for materials and messaging you can share through your unique channels. 
Please also help us remind your contacts that the Governor has mandated wearing masks in public. We are pushing that message out on our social channels and hope you'll help share it. 

Thank you again for your partnership, and for all you are doing to support and assist Coloradans during this very difficult time. 
Kim Bimestefer
Breaking News
Non-Emergent Medical Transportation Update
Non-Emergent Medical Transportation (NEMT) is a Health First Colorado benefit for members who don't have transportation to medical appointments. NEMT used to be administered by different vendors in different parts of the state, but is now provided through one transportation broker,  IntelliRide. This will help improve customer service and help ensure more consistent, streamlined operations and improved access for members.
All transportation requests and requests for mileage reimbursement should be submitted to IntelliRide. 

Members and assistors can contact IntelliRide at 1-855-489-4999 or 303-398-2155 (State Relay: 711) or  visit their website for more information.

For more information about the statewide transition to IntelliRide, email more information about the NEMT benefit, visit our website.
Healthy Communities Transition to the Accountable Care Collaborative
Effective July 1, 2020, the Department transitioned the work of the Healthy Communities Program to the Department's Regional Accountable Entities (RAEs).

Historically, the Healthy Communities program provided outreach to newly enrolled families with children under the age of 21 and pregnant women enrolled in Health First Colorado (Colorado's Medicaid program) and Child Health Plan Plus (CHP+). Moving forward, this outreach will be performed by the RAEs and Managed Care Organizations (MCEs) as it aligns well with their existing work and provides cost savings opportunities.

We would like to thank the many Health Communities staff members and partners who worked so hard to help improve the lives and health of the people we serve.

RAEs will now handle Health First Colorado member questions concerning providers and benefits. County departments of human/social services will answer questions about member applications and eligibility status. CHP+ customer service will answer any CHP+ member questions at 1-800-359-1991.

For more information, contact Jeff Helm.
We're Here for YOU, Colorado!
As many Coloradans struggle with job loss resulting from the coronavirus (COVID-19) pandemic, the Department is here to keep Coloradans covered with health insurance through Health First Colorado (Colorado's Medicaid Program) and Child Health Plan  Plus  (CHP+).  

It's critical that Coloradans know they can apply for health coverage at any time and it's easy to do. 

Please help us spread the word. We have created materials for distribution by our many partners to help Coloradans who need health care coverage, and to help us recruit more health care providers to help serve our more than 1.3 million current members and the more than 500,000 new members we expect to enroll by the end of this year. 

For more information on the anticipated enrollment surge, read the  press release.

If you need content or a format type that isn't listed here, we are happy to customize materials for you. Just email  

Thank you for helping us ensure all Coloradans have access to health care coverage during this public health emergency and beyond!  

For more information, visit
We Need Your Help!
We need your help spreading the word about our need for more Health First Colorado (Colorado's Medicaid program) providers to deliver care to Coloradans.
We need more providers NOW to help treat the influx of new Health First Colorado members. We are asking you to help us by spreading the word to your network about our immediate need.
As a result of the novel coronavirus disease (COVID-19) pandemic, the Department is asking health care providers to join us in ensuring all Coloradans have access to quality health care during this public health crisis by becoming a Health First Colorado provider.
Currently, the Department is offering incentives to increase provider enrollment and help provide an important public service. In an effort to increase provider enrollment, the Department is:
  • Allowing temporary enrollment for providers during the federally designated COVID-19 emergency.
  • Waiving the application fee and fingerprinting process for applicable providers.
  • Waiving site surveys for applicable providers.
Key Health First Colorado Provider Benefits
  • We Pay FAST: Health First Colorado pays faster than private payers, with claims paid weekly and deposited directly into a business account.
  • Enrollment is Quick and Easy: Online enrollment means you can become a provider in just a few weeks.
  • Quick Customer Service: Our Provider Services Call Center answers calls in less than two minutes on average and regional provider field representatives are available to assist you with more complex questions.
  • Customize Your Patient Experience: As a Health First Colorado provider, you have full control of the number of Health First Colorado patients you see, as well and whether or not your practice is published in our online Provider Directory.
Why Become a Provider?
Becoming a Health First Colorado provider gives you the opportunity to improve the health and well-being of more than one million Coloradans. Health First Colorado is more than health insurance -- it is a vital public service, helping nearly a quarter of our state's residents stay healthy or move toward better health.
If you know someone who might be interesting in becoming a Health First Colorado provider, please ask them to visit the Provider Enrollment website at  or call the Provider Services Call Center at 1-844-235-2387 Option 2, then option 5.
Resources for Coloradans Impacted by COVID-19 can help connect Coloradans with services, funds and jobs during the COVID-19 pandemic. This resource is the result of collaboration with the Governor's Office, state agencies, community partners and Bitwise Industries. Please visit the website and share with anyone who is struggling, or may need the help: 
Registration Open at Connect to Care Jobs Site
The State of Colorado is working to help alleviate the shortage of qualified workers in the health care industry, especially for skilled nursing facilities, assisted living residences and other residential care facilities. The new Connect To Care Jobs site connects health care employers with job seekers looking for opportunities in the health care industry. 
There are nearly 700 job seekers registered on the   Connect To Care Jobs  site right now. Approximately 200 of those are looking for CNA or other direct care positions and another nearly 300 are seeking nursing positions. 
Skilled Nursing Facilities, Assisted Living Residences, Intermediate Care Facilities, and Residential Care Facilities, can begin registration now by completing this survey . Please note: O nly the facility types which are licensed by the Colorado Department of Public Health and Environment will be allowed to register. For the complete registration process, refer to this checklist
Prospective employees can register at the Connect To Care Jobs site now. 
For more information about Connect to Care Jobs in Colorado, visit our informational website .
Health Care Affordability
Alternative Payment Model (APM) Participants: Submit eCQMs by Aug. 14
Are you a primary care medical provider (PCMP) participating in the Health First Colorado (Colorado's Medicaid program) Alternative Payment Model (APM)

If so, your regional accountable entity (RAE) may soon be in contact to collect structural and claims attestation for the 2019 program year. Please submit your electronic clinical quality measures (eCQMs) for the 2019 program year through the eCQM form. Submissions are due Friday, Aug. 14. If your office cannot submit data, email your RAE to request an exemption no later than Aug. 14. If you have questions, email your RAE for support. Thank you for participating in the APM.

Alternative Payment Model Participants: Opportunity to Switch Claims Measures
Primary Care Medical Providers (PCMPs) recently received refreshed claims data for the APM 2019 calendar year in order to gain insight into 2019 performance. PCMPs can also evaluate their 2020 program year claims measures and determine whether the measures selected are actionable or if alternate measures should be selected. If a PCMP decides to change claims measures, they should email their Regional Accountable Entity (RAE) by July 31. The Department also created  a guide  and a short  video tutorial  to help PCMPs navigate the reports. PCMPs can connect with their RAE if additional support is needed.   

Alternative Payment Model Participants: Do you have Colorado Data Analytics Portal (CDAP) access yet? 
Effective Aug. 7, the Colorado Data Analytics Portal (CDAP) will house refreshed quarterly data reports for primary care medical providers (PCMPs) participating in the Alternative Payment Model (APM) program. CDAP will display practice- and member-level data for all APM measures to help providers identify gaps in care and intervene to provide quality, coordinated care.

More than 200 PCMPs currently need CDAP access. Please connect with your regional accountable entity to request access.

For more information, contact Natasha Brockhaus.

Hospital Transformation Program Update
HTP Contractor update  
This notice is to inform stakeholders that the State of Colorado's contract with Public Consulting Group (PCG) for services related to HTP has ended. As such, PCG will no longer be providing services relative to the HTP. Please direct any HTP-related questions to the  HTP inbox .  
Rural Support Fund Update: Provider Application and Agreement   
The Rural Support Fund is an integral part of HTP. The purpose of this fund is to assist rural hospitals' transition towards a sustainable delivery model, with $12 million available annually for each of the five years of the HTP  waiver. This dedicated   funding will help  rural hospitals prepare for future value-based payment environments.  

In the future, the Department will host policy guidance and workshops, with the Rural Health Fund application timeline aligning with HTP hospital application.  

Hospital Quality Incentive Payment (HQIP) program update  
The proposed measures for the 2021 HQIP program have been updated and are on the  HQIP website . These measures have been reviewed and recommended with consensus by the HQIP subcommittee and HTP Community Advisory Council. However, final approval from the Colorado Healthcare Affordability and Sustainability Enterprise Board (CHASE) is still pending. Once approved, the full measure details will be published on the Department's website.  
Community Advisory Council  
A Community Advisory Council meeting was held on  Friday,  June 26.  The agenda and previous meeting notes is on the  Community Advisory Council website .  

If you'd like to know more about the HTP, visit  the HTP website   and read past editions of the HTP Newsletter in  our online archives.
For more information about HTP, contact Courtney Ronner.

Medicaid Cost Control
Ensuring Appropriate Claims Payment Project
The Department is executing its Ensuring Appropriate Claims Payment project in late fall 2020. The project has two main components: implementing the new ClaimsXten tool and applying improvements to the existing 3M EAPG solution to improve payment accuracy. 
In preparation for the Department's rollout of the project, an informational webinar will be forthcoming. All providers are encouraged to attend the webinar for details about the rollout of ClaimsXten and the upcoming improvements to the 3M EAPG solution. 
The Department will also be announcing provider training sessions. These sessions will be conducted by the Department's vendor and will provide technical guidance. 
For up to date information about the project and upcoming milestones, visit
For more information, contact
Operational Excellence
Public Comment Period for Colorado's Title XXI Section 1115 Demonstration Extension Application  
The Department is seeking public comments on a title XXI Section 1115 Demonstration Extension Application. The deadline for public comments is Aug. 10.
The application requests an extension of the current waiver program from  Aug. 1, 2020, through July 31, 2025. This extension would allow the Department to continue to receive title XXI funds to support the improvement of health outcomes for low-income mothers and their babies by providing necessary prenatal, delivery and postpartum care to eligible Child Health Plan  Plus (CHP+) members who are pregnant. The application will not request or include any program changes, only an extension through July 2025.

To learn more or comment on the application or evaluation, visit our website or contact us at 
For more information, contact Jeff Jaskunas