This Department of Health Care Policy & Financing (HCPF) newsletter is designed to inform county directors, management and staff about high-impact updates, important changes, county performance, new guidance, and program changes.

Message from the Executive Director

Call to Action: Keep Coloradans Covered



HCPF created resources for you to share in public areas — flyers, posters, messaging, social media, and more. Please use these resources today to help us renew those who continue to qualify for our safety net health coverage programs and connect those who no longer qualify for our programs to affordable, alternative coverage.

Providers, educators, counties, community leaders and advocates — you are our trusted messengers on the ground, seeing our members when they walk through your doors. We ask that you meet them where they are, post flyers, send notifications, make phone calls, talk to them when they’re in front of you, and remind them to open mail from the state, complete, sign and send in the packet by the renewal deadline.

• HealthFirstColorado.com/renewals has plain language resources in English and Spanish with links to help members with what they need to know about the renewal process and where to find help completing a renewal.
• It is common for members to miss their renewal deadline. Members should submit the renewal packet they already received if they are within the 90-day window of their renewal anniversary. If they do not take action within those 90 days, they must reapply (fill out and submit a new application) to regain coverage if they are eligible. 
• The renewal process may take longer for individuals with disabilities who access HCBS waiver supports. Please encourage members who receive waiver services and their support community to take action early and seek help with their renewals if they need it. HCPF is actively working with advocates, Regional Accountable Entities, case management agencies and counties to implement initiatives that focus on these members. 
• Please remind parents that children may still qualify for Health First Colorado or CHP+ coverage even if the parents no longer do.

Long-Term Care (LTC) and Buy-In Renewal Extension

A CBMS update will automatically extend the renewal period for 60 days for Long-Term Care (LTC), individuals on Waivered Services, and Buy-In recipients who have yet to return their renewal packet on time during COVID Unwind.  

HCPF is providing an additional 60-day extension to assist our vulnerable populations, including Long-Term Care (LTC), individuals on Waivered Services, and Buy-In recipients who have not returned their renewal packet on time during COVID Unwind.  

CBMS will add 60 days to September renewals for vulnerable populations, including Long-Term Care (LTC), individuals on Waivered Services, and Buy-In recipients who do not return their renewal packet on time. This does not include cases that have already closed.

Action: Below are resources for eligibility workers that provide additional information and data entry guidance.     

• The Staff Development Division (SDD)
• MA Renewal for LTC & Buy-in Population Desk Aid 
• Navigate to the Document Library on the website and find the above titled desk aid in the Long-Term Care folder
•  The COVID Resources for County and Edibility Partners  
• Aug. 24 HCPF/Eligibility Sites COVID Unwind Touch Base Meeting
• Slide Deck (coming soon)
• Recording 

Contact: Any questions regarding this communication may be directed to hcpf_medicaid.eligibility@state.co.us.

PHE Unwinding Reporting

HCPF will be reporting its progress on “unwinding” the continuous coverage requirement to the federal government. HCPF will link these reports on the Continuous Coverage Unwind Data Reporting page and include links to this information in our monthly COVID-19 newsletter.

The information reported to the Centers for Medicare & Medicaid Services (CMS) is point in time data about renewals as required by federal reporting and does not include all the new members coming into the program or those who will take action during the 90-day reconsideration period. Members can resume coverage if they still qualify by returning their renewal packet and any missing information to their county for processing within 90 days of losing coverage. Based on pre-pandemic information, on average, about half of the members who had lost eligibility were deemed eligible for Medicaid again within two years.

FAQs about unwinding reporting is in the PHE Resource Center.

Temporary Extension for All Members Up for Renewal

HCPF will be temporarily extending members’ renewals due in September and October who have not yet submitted their renewal packet. This is to comply with recent federal guidance. This will be done this evening, Tuesday, Sept. 5.

HCPF received new guidance from the Centers for Medicare and Medicaid Services (CMS) on Aug. 30, 2023, that requires a change to the ex parte process for renewals. Instead of renewing members with ex parte at the household level (all members of a household receiving Health First Colorado or CHP+ benefits reviewed for eligibility at the same time), CMS is requiring states to perform ex parte reviews on an individual basis, meaning each person in the household is reviewed and approved separately. This new guidance will require significant changes to our eligibility system that will need to be done in a phased approach. As a result, HCPF is implementing a temporary renewal extension for all members up for renewal in September and October until we implement a short-term system change in mid-October to bring us into compliance with CMS guidance. The extension and short-term system change will not impact the member’s experience of the renewal process. Members are strongly encouraged to complete, sign, and return their renewal packet right away.

Action: New functionality is not being added. This means no additional action is needed from eligibility workers beyond normal processing of renewals. Similar to the Long-Term Care (LTC) and Buy-In Renewal Extension, the extension will be done systematically by setting the Data Entry Complete field in CBMS to No on the Case Wrap up screen. This is for September and October Medical Assistance renewals in which a renewal packet has not yet been started and will prevent a termination for failure to return the renewal packet. This will not affect renewals that have been started in CBMS and are already in progress.

Renewals that are received from members should be started in CBMS within 24-48 hours of receipt and processed accordingly. Once data entry is complete, eligibility workers must manually update the Data Entry Complete field to Yes and run eligibility.

Contact: hcpf_medicaid.eligibility@state.co.us

All memos and their attachments are on the Memo Series website.

None

None

Review existing training material on pending cases in CBMS due to Long-Term Care (LTC) Level of Care (LOC) and Disability Determination.

HCPF is requesting eligibility workers review the existing training materials on pending a case during intake, renewal, and ongoing in CBMS for LTC LOC and Disability Determinations to keep a case from closing incorrectly when these items are still outstanding with a Case Management Agency and/or the state disability vendor.

HCPF has received concerns that members could be incorrectly terminating or denying for a Level of Care determination and/or Disability Determination. Eligibility sites are being directed to please review the following training materials to ensure these cases pend when needing a Level of Care and/or Disability Determination. The Staff Development Division (SDD) has existing detailed web-based training (WBT) and process manuals that provide a step-by-step process for entering and pending cases for LTC LOC and Disability Determinations.

The Process Manuals provide:

• The steps to pending a case in CBMS for LTC LOC or how to enter the LTC LOC once the Case Management Agency has provided it to the eligibility site.
• A step-by-step process for how to enter a Disability Determination into CBMS or pending a case for a Disability Determination. 

The WBTs provide Detailed instructions for:

• Disability Determination in the Health First Colorado Buy-In Program WBT 
• LOC information in the Long-Term Care (LTC) Categories & Special Circumstances WBT

Each of these WBTs has Instructor-Led Training attached, where the instructor outlines and guides eligibility workers to practice the data entry in the CBMS using the TRN Environment.

Action: Below are the existing Process Manuals and WBTs eligibility workers should review for data entry guidance.  

• https://training.colorado.gov/
• Entering and Pending for an LTC Level of Care Process Manual
• Entering a Disability Determination Process Manual

• COLearn
• Health First Colorado Buy-In Program WBT
• LTC Categories & Special Circumstances WBT

Additional Resource: The County Dashboard LTC Board will display Level of Care certifications due within the next 60 days and Disability Diary Dates expiring within the next 60 days for Long-Term Care. This information is updated via nightly batch. Please consider using this information to proactively plan on supporting members with the information needed to renew the LOC or Disability status and connect with appropriate partners for a timely determination of LOC and/or Disability.

Contact: Any questions regarding this communication may be directed to hcpf_medicaid.eligibility@state.co.us.

Processing Incarcerated Applications

As a reminder, Medicaid applications must be processed regardless of incarceration. Applications should be approved and placed into incarcerated status if the individual is otherwise eligible and incarcerated at the time of the determination. Please see below where this is referenced in rule: 

8.100.3.G.1.b.ii. Inmates who are incarcerated in a correctional institution such as a city, county, state or federal prison may be enrolled, if eligible, with benefits limited to an inpatient stay of 24 hours or longer in a medical institution.

Thank you for your support in ensuring Coloradans have timely access to their benefits.

Partner Webinars

HCPF will be hosting quarterly informational sessions about the end of the Continuous Coverage Requirement and the COVID-19 public health emergency. These webinars are geared toward community partners such as advocacy organizations, providers, and community organizations who may provide other assistance to Health First Colorado or CHP+ members (housing, social services, etc). 

The presentation and recording from the July 26, 2023, PHE Unwinding webinar are posted in the PHE Resource Center.

Next Webinar Information

When: Oct. 25, 2023, 1 - 2:30 p.m. Mountain Time

Register in advance for this webinar.

After registering, you will receive a confirmation email containing information about joining the webinar.

We would like your feedback on the format of future webinars to ensure they are productive for all. Please take a moment to take this survey to inform the structure of future webinars.

New Training Released - RRR/Renewal

In collaboration with our HCPF and CDHS partners, the Staff Development Division has released a new training volume titled RRR/Renewal.

This volume will take the learner through the basics of an RRR/Renewal, as well as dive into more specific information and actions for each High-Level Program Group (HLPG) to include, Medical Assistance, SNAP, Adult Financial (AF), Colorado Works (CW), and Long-Term Care (LTC). 

With this new volume, the following web-based trainings (WBTs) have been released in COLearn:

• RRR/Renewal Basics 
• Medical Assistance Renewals 
• SNAP RRR 
• SNAP PRF 
• AF RRR/Renewal 
• CW RRR/Renewal 
• LTC RRR Part 1 
• LTC RRR Part 2

The RRR/Renewal training can be accessed in COLearn by following one of the steps below: 

1. New workers will find this new volume as part of the HLPG curriculums accessed by clicking on the program’s bubble on the Welcome Page. 
2. Existing workers will find this new volume by clicking on the RRR/Renewal link in the Experienced Worker section on the Welcome page under the header Self-Guided Playlists by Topic.

This new volume will also include the following desk aids located in the Document Library on Training.colorado.gov:

• Acceptable Forms for RRR/Renewal (updated)
• MA Processing Information
• PRF Processing 
• SNAP Processing Information 
• SNAP Rescind, Reinstatement, Reopen 
• SNAP Late Verification Flowchart
• AF/CW RRR/Renewal Checklist 
• Late RRR/Renewal, Late Verifications and Missed Interview related to Good Cause 
• Child Support Pass Through 
• Income Trust Ledger

Contact: For questions regarding this training, please email the Staff Development Division at soc_staffdevelopment@state.co.us.

How can you help support members during the PHE unwinding process?

HCPF has developed extensive partner toolkits regarding the end of the continuous coverage requirement. Update Your Address, Understanding the Renewal Process and Take Action on Your Renewal toolkits all include resources to help members take action to keep their coverage. A new joint webpage KeepCOCovered.com includes partner resources and information for those who may need to transition to other health coverage. Flyers have recently been developed for Colorado employers to distribute to their employees to help spread the word.  

You can help us raise member awareness about the renewal process by sharing the messaging in our toolkits. The materials in the toolkits identify key actions for members to take: updating contact information, taking action when a renewal is due, and seeking help with renewals at community or county resources when they need it. Flyers, social media messaging and graphics, website content, and other outreach tools are in our PHE Planning Resource Center. Partners can also educate themselves and their staff on the basics of the renewal process to assist members who may need help. See our Renewal Education toolkit. 

Frequently Asked Questions (FAQs) about the end of the continuous coverage requirement and return to regular renewal processes are available in the PHE Planning Resource Center. Members with questions about the renewal process can learn more by visiting Health First Colorado’s renewal webpage available in English and Spanish.

HCPF - New COVID-19 Unwind Resources

HCPF is releasing this communication to inform eligibility sites of two new COVID-19 unwind resources.

Details:

1. The End of Public Health Emergency for COVID-19 and Returning to Normal Operation memo, on the 2023 memo series webpage. 

1. A COVID-19 unwind section has been added to the Eligibility and Resource HCPF webpage under the FAQs and Training section, which includes the following:

• The COVID-19 Unwind Educational Session held on Feb.15, 2023 
• The webinar recordings  
• The presentation materials
• COVID-19 Unwind FAQs
• COVID-19 Unwind MA Renewal Ex-Parte Flowchart Desk Aid

Questions regarding this communication may be directed to: hcpf_medicaid.eligibility@state.co.us.

Do you need help? Do you have a question? Does a case need to be escalated? There are two ways you can contact the HCPF County Relations team.

1. County Relations Web Form. Try this method first. It allows you to enter details to help us resolve your issues.
2. County Relations Email. You can still email us at hcpf_countyrelations@state.co.us. Your email to us will automatically create a service ticket with your email included. We cannot open encrypted messages within our ticketing system.

HCPF Contacts & Resources

Staff Development Center (SDC) Homepage

CO.Learn/Learning Management System Login

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