At a Glance is a Department of Health Care Policy & Financing (HCPF) publication that provides information on major initiatives, policy changes and program updates. Feel free to share At a Glance with your colleagues. Find previous editions of At a Glance on our website. Thank you for your interest!

Collabortaing Through a Challenging Chapter

The state is in the midst of balancing a challenging budget, with the Joint Budget Committee (JBC) making difficult balancing decisions over the coming weeks. A contributing factor is the mismatch between medical inflation and related Medicaid cost trends versus TABOR’s impact on available revenues. At the same time, the evolving federal landscape may also impact Medicaid's fiscal challenges. It will take all of us working together to navigate this reality.

HCPF’s Medicaid Sustainability Framework seeks to organize emerging concepts and strategies to enable the thoughtful navigation of this multi-year, fiscal challenge while fostering partnership and collaboration to achieve shared goals. The six points of this framework include: 

1. Address Drivers of Trend: Better address all the controllable factors that drive Medicaid cost trends. 
2. Maximize Federal Funding: Leverage and maximize HCPF’s ability to draw down additional federal dollars. 
3. Invest in Coloradans: Continue investing in initiatives to drive a Colorado economy and educational system to reduce the demand for Medicaid over the long term as Coloradans rise and thrive.
4. Make Reasonable Medicaid Cuts or Adjustments: Identify where programs, benefits, and reimbursements are comparative outliers or designed in such a way that we are seeing - or will experience - higher than intended trends or unintended consequences.
5. Reassess New Policies: Consider pausing or adjusting recently passed policies not yet implemented. 
6. Exercise Caution in Crafting Increases to the Medicaid program going forward.

For your convenience, we are providing links to our fiscal year 2025-26 Budget Agenda Summary, Joint Budget Committee budget hearing documents, and December message on the HCPF budget. 

We continue to monitor and respond appropriately and thoughtfully to federal actions impacting our programs and will keep you posted with quick but informative communications, as needed. 

HCPF’s 2025 legislative agenda includes proposals that merge waivers for children with complex health needs, ensure Medicaid is the payer of last resort with commercial carriers, create a cash fund to support 1115 Demonstration Waiver programs, and create a permanent waiver program offering benefits to specific members. We also welcome your review of our Jan. 22 SMART Act hearing materials and our fiscal year 2023-24 annual report to the community to learn more about HCPF’s strategic priorities, opportunities and challenges, legislative agenda, performance against published goals, and more. 

Thank you to all who attended our recent Hospital Transparency Reports Webinar. These reports measure Colorado hospital profits, reserves, costs, expenses and the level of community benefit that tax-exempt hospitals offer their communities in lieu of paying taxes. Hospitals are essential pillars within the communities they serve. These reports provide insight into hospital financial health. The reports and materials are on our website. 

Thank you for your collaborative partnership and thoughtful engagement. We truly appreciate it. 

Feedback Requested on County Administration Rule Changes:

Beginning in December 2024, HCPF began to solicit input on the County Administration Rules. HCPF's County Administration rules govern the Medical Assistance fiscal and programmatic operations of the county departments of human/social services (counties). These rules set standards for fiscal and program compliance, customer service, non-discrimination and accessibility, and more. These rules do not apply to eligibility determinations or actions taken in the eligibility determination system. 

We are encouraging providers, advocates, members, and the general public to provide feedback on the suggested changes to the rules. Interested parties can provide feedback by providing written comments or by participating in a stakeholder meeting. A full list of stakeholder meetings, a copy of the suggested changes to rules, and the comment form are on the county rulemaking webpage.  

Bariatric Surgery Rule Revision Stakeholder Meeting March 13: 

Thank you to everyone who participated in the first stakeholder meeting on Jan. 23. We appreciate your valuable feedback and invite you to join us for the second meeting in this series:

Meeting 2: Thursday, March 13, 2025

Time: 9:30 a.m. to 12:30 p.m.

Location: Virtual via Zoom (Register in advance)

During this meeting, HCPF staff will continue discussions on revising the bariatric surgery rule. Building on feedback from the Jan. 23 meeting, staff will present refined language changes and facilitate further discussion on key areas of the rule. Stakeholders will have the opportunity to provide additional input and share any supporting documentation or research.

We encourage attendees to review the current rule and the recording of the Jan. 23 meeting before participating. 

Meeting Accommodation and Language Access Notice: Auxiliary aids and services for individuals with disabilities and language services for individuals whose first language is not English may be provided upon request. Please notify us at HCPF_Stakeholders@state.co.us at least one week prior to the meeting to make arrangements.

Las ayudas y servicios auxiliares para individuos con discapacidades y servicios de idiomas para individuos cuyo idioma materno no sea inglés pueden estar disponibles por solicitud. Comuníquese con nosotros a HCPF_Stakeholders@state.co.us al menos una semana antes de la reunión para hacer los arreglos necesarios.

Provider Services Call Center Vendor Transition May 1, 2025: 

Providers are reminded that management of the Provider Services Call Center will transition from Gainwell to OptumInsight (Optum). On May 1, 2025, Optum will officially take over management of the Provider Services Call Center.  

What providers should know 

• The Provider Services Call Center phone number will change. HCPF will announce the new phone number closer to the transition.  
• Optum is only taking over management of the Provider Services Call Center. Gainwell will continue as the vendor for the Colorado interChange and the Provider Web Portal. 
• This vendor change will only apply to the Provider Services Call Center. The Care and Case Management (CCM), Dental, Pharmacy, Electronic Visit Verification (EVV) call centers will not change. For a complete list of assistance resources, visit the Provider Contacts webpage.  

Why is HCPF transitioning to Optum? 

Gainwell’s contract to oversee the Provider Services Call Center ends this spring, and HCPF has selected Optum to take over as the new vendor for the Provider Services Call Center.  

HCPF will share more information about changes providers should be aware of as the transition approaches. Some changes will include: 



• A new phone number. 
• Providers will be offered an after-call survey to provide valuable feedback about their call. 
• Providers will be able to use their National Provider ID or the Health First Colorado ID. 

Visit the Colorado Medicaid Enterprise Solutions (CMES) Transition webpage for more information.  

Working Adults with Disabilities Stakeholder Meeting:

The Health First Colorado Buy-In Program for Working Adults with Disabilities allows adults with a qualifying disability "buy-into" Health First Colorado (Colorado Medicaid).

Members who work and earn too much to qualify for Health First Colorado may qualify for the Buy-In Program. Interested stakeholders are invited to one of two virtual stakeholder meetings to learn about updates to the Working Adults with Disabilities Buy-In Program effective July 1, 2025.

HCPF staff will present an overview at these meetings of the changes being made to how Health First Colorado members enroll into the Working Adults with Disabilities Buy-In Program. These changes will specifically impact Health First Colorado Members who also receive services through Home and Community-Based Services (HCBS) waivers. Attendees are invited to learn and ask questions about the upcoming changes. These two meetings are identical and therefore attendees only need to choose the meeting date and time that best fits their schedule.

Meeting date and time: Feb. 20, 11 a.m. to 12 p.m. and March 13, 1 to 2 p.m.

Registration and location: these meetings will be virtual via Zoom. Register in advance for the meetings.

Register for the meeting on Feb. 20

Register for the meeting on March 13

Attendees will receive a confirmation email after registering with information about joining the webinar.

A recording of the meeting may be requested by emailing Kyra Acuna at

HCPF_stakeholders@state.co.us.

Refer to the Health First Colorado Buy-In Program For Working Adults With Disabilities webpage for more information about the program.

Meeting Accommodation and Language Access Notice: Auxiliary aids and services for

individuals with disabilities and language services for individuals whose first language is not English may be provided upon request. Contact Kyra Acuna at HCPF_stakeholders@state.co.us at least one week prior to the meeting to make arrangements.

Member Correspondence Improvements:

HCPF is holding a series of quarterly virtual stakeholder meetings to present information about ongoing improvements to member correspondence.

At the meetings, HCPF staff will share

• updates on improvements being made,
• timelines for making changes,
• plans for future letter improvements, and
• opportunities for stakeholders to stay involved.

Attendees will be able to submit questions to be answered live when possible. Frequently asked questions will be posted on the Member Correspondence Improvements website following the meeting. Attendees will also be able to submit feedback via Google form for two weeks following the meeting.

The meetings will be in English and Spanish. ASL interpretation will be provided.

Meeting dates and times: 

• Thursday, April 17, 2025, 12 to 1 p.m.
• Thursday, July 17, 2025, 12 to 1 p.m.
• Thursday, Oct. 16, 2025, 12 to 1 p.m.

Please register for the meetings in advance. After registering, you will receive a unique link to join the meeting. For those who cannot attend the meetings, you may request a recording.

Meeting Accommodation and Language Access Notice: Auxiliary aids and services for individuals with disabilities and language services for individuals whose first language is not English may be provided upon request. Please notify the Stakeholder Engagement Section at HCPF_stakeholders@state.co.us at least one week prior to the meeting to make arrangements. 

If you have general questions, please contact the Stakeholder Engagement Section at HCPF_stakeholders@state.co.us for more information. 

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Mejoras de la Correspondencia de los Miembros

Health First Colorado está trabajando para mejorar las cartas de miembros y están planeando cambios basados en los comentarios de miembros y las partes interesadas.

Para aquellos que no puedan asistir, una grabación será compartida después y publicada en la página web de correspondencia de miembros.

Los asistentes también serán capaces de someter comentarios a través de un formulario en línea por dos semanas después de la reunión.

Fechas y horarios de las reuniones: 

• Jueves, 17 de abril de 2025, de 12 - 1 p.m.

• Jueves, 17 de julio de 2025, de 12 - 1 p.m.

• Jueves, 16 de octubre de 2025, de 12 - 1 p.m.

Por favor, registrarse para las reuniones con anticipación. Después de registrarse, Usted recibirá un enlace único para unirse a la reunión. 

Las reuniones serán en inglés y español. Se proporcionará interpretación en lenguaje de señas (ASL, por sus siglas en inglés).

Aviso sobre las adaptaciones y el acceso lingüístico para las reuniones: Ayudas y servicios auxiliares para individuos con discapacidades y servicios de lenguaje para individuos cuya primera lengua no sea el inglés puede ser proporcionado bajo solicitud. Por favor, notifique a la Sección de Compromiso con las Partes Interesadas a HCPF_stakeholders@state.co.us al menos una semana previa de la reunión para hacer los arreglos.

Si usted tiene preguntas generales, por favor comuníquese con la Sección de Compromiso con las Partes Interesadas a HCPF_stakeholders@state.co.us para más información.