This Department of Health Care Policy & Financing (the Department) newsletter is designed to inform county directors, management and staff about high-impact updates, important changes, county performance, new guidance, and program changes. |
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Message from the Executive Director |
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A Look Back and Thank You Before We Look Forward Together
Thank you for your partnership in another unprecedented year for health care. Together, we successfully served an additional 375,000 Coloradans in need – an increase of 30% - since the start of the pandemic. We are covering 1.62 million Coloradans, or one in four as we begin this new fiscal year. Clearly, our safety net programs have helped keep Coloradans covered through the economic downturn, with an uninsured rate steady at around 6.6%.
Your support in improving care access to meet the needs of so many more members during a pandemic has been critical. Together, we expanded our provider network by 28% over the past few years, with 95,000 providers now enrolled in Health First Colorado. That includes more than 10,000 active behavioral health providers. A very special thank you to the General Assembly and the Joint Budget Committee for their 2% across the board provider reimbursement rate increase effective July 1, for the specific rate increases propelled through our Medicaid Provider Rate Review Advisory Committee (MPRRAC) process, and for the wage increases for certain direct care and nursing home workers – all critical to supporting our providers in their quest to take good care of our members, reduce disparities, improve quality and increase provider access overall.
Together, we also successfully directed American Rescue Plan Act (ARPA) funding towards a number of meaningful, impactful, transformational projects to the betterment of our providers and those we serve, such as: strengthening the behavioral health safety net, stabilizing behavioral health crisis services, improving behavioral health access and integrating behavioral health into primary care; improving the affordability and accessibility of rural care; addressing health disparities with a focus on COVID-19 vaccination rates; targeting services to high-risk populations, especially individuals with disabilities and our older adult members; and investing in the health care workforce.
We also continued to improve the customer experience – for members and providers. Our Member Call Center answered calls in less than 30 seconds on average, all year. Special thanks to our counties and medical assistance sites for your partnership and collaboration. Our investments in 50+ CBMS system enhancements and other modernizations are paying off. The initial eligibility and renewal processes are more member-focused and automated, with 97% of applications approved within 45 days and projected reductions in error rates and rework. Missing information in eligibility correspondence is down to 0.012%, which is a massive improvement. And now, members can view coverage status and update information real-time online through PEAK, our online portal. For our providers, claims are processed in less than four days and provider calls are answered in an average of less than one minute. Together, we have handled the 30% membership growth without any major operational issues, which is an accomplishment we should celebrate together.
Amidst this growth, we kept Health First Colorado cost trends flat while evolving innovations that improve quality, reduce disparities and improve the health of our members as well. Our health care affordability leadership in value-based payments, prescription drug and hospital cost control will continue to help us manage our own budget (1/3 of the state’s overall budget), while helping save Coloradans and employers money on health care as well.
Thank you for your partnership on these important endeavors. Please feel free to view our performance on Administration goals at dashboard.colorado.gov.
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HCPF - HCBS-SCI Waiver Statewide Expansion and Name Change Effective July 1, 2022 |
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The purpose of this communication is to advise eligibility sites of the statewide expansion of the Home and Community-Based Services (HCBS) Spinal Cord Injury Waiver (HCBS-SCI Waiver), announce the new waiver name, and announce the removal of county restrictions.
Effective July 1, 2022, the HCBS-SCI waiver will be available for enrollment statewide and by removing the county restrictions, eligible members may now enroll in this waiver from anywhere in Colorado. The name of the HCBS-SCI waiver will be changed to the HCBS Complementary and Integrative Health Waiver (HCBS-CIH Waiver). This waiver has been expanded to include six additional qualifying medical conditions.
The new six qualifying medical conditions for this waiver now include (traumatic and nontraumatic): multiple sclerosis, brain injury, spina bifida, muscular dystrophy, or cerebral palsy with the inability for independent ambulation resulting from one of these conditions.
The name change transition for case management agencies, eligibility sites, and affected state departments can begin immediately. The use of the term “the HCBS-SCI waiver” will be retained in the Benefits Utilization System (BUS), the Colorado Benefits Management System (CBMS), the Bridge, and eligibility verification/benefit plan information maintained in the Colorado interChange Medicaid Management Information System (MMIS) until the new Care and Case Management system goes live. The Department will send out further information as system changes occur.
The Level of Care Certifications submitted to eligibility sites will not be updated to include HCBS-CIH. LOC Certifications will continue to read HCBS-SCI.
If you need additional information or have questions please contact Kacey Wardle.
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HCPF - Email address for Disability Application Submissions has changed |
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The purpose of this communication is to remind you that the email address for Disability Application Submissions changed July 1, 2022, and all Disability Application Submissions will need to be submitted to [email protected]. ARG remains the state contractor for disability applications; the submission email address is the only thing changing.
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Recent Memo Series Issued to Counties |
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OM 22-039
The purpose for this memo is to notify eligibility site staff of the income guideline updates for the Child Health Plan Plus (CHP+) program effective July 1, 2022.
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To better track and respond to complaints from members that are directed to our county partners and then forwarded to HCPF, we have implemented Salesforce ticket tracking as our process going forward. Please have members submit any complaint, whether related to a state contractor (Intelliride, for example), a county or another Medicaid-related matter, using either the email or webform below.
- [email protected]
- We just ask for information that would help us identify who needs help and for what issue
- HCPF County Relations Salesforce webform
- This collects the necessary information for us to act
- Select ticket type "Member Complaint"
- Note: a new, member-focused webform is being developed, so use this link until the new one is provided
- It is a best practice for the member to submit the complaint, through either channel, themselves, but only so they receive the correspondence tracking back. County staff-submitted complaints are absolutely accepted, but that staff will be receiving the tracking emails instead of the member.
As a reminder, this process is identical to the standardized state complaint process we discussed in May/June 2022, which formalizes what is already an existing process, and adds Salesforce tracking.
We are also still taking any feedback on the complaints process and memo, so please send that along to HCPF_CountyRelations. Let us know if you'd like to include this for further discussion in future meetings. |
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Child Health Plan Plus Update
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In an effort to remove barriers for families seeking health coverage, the Department of Health Care Policy & Financing (the Department) and the Colorado General Assembly championed a health care bill that also included an amendment to eliminate the CHP+ enrollment fee at intake and renewal. Effective July 1, 2022, the enrollment fee will no longer be required at intake for the CHP+ program. The requirement to collect an annual enrollment fee for CHP+ at renewal is currently suspended due to the Public Health Emergency (PHE) and will be presented to the Medical Services Board (MSB) for formal adoption in September of 2022.
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HCPF - Completing Renewals for Medical Assistance Programs |
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This communication is a reminder that eligibility sites must continue to process and complete renewals received during the Public Health Emergency (PHE).
Per Policy Memo 20-004, eligibility sites are required to continue to work case changes, renewals, and verifications. If a renewal is not processed timely, the renewal date will advance because of the PHE locked-in logic. Eligibility sites need to update the case using the renewal packet or any verifications received. This will ensure that cases are updated with current information reported by a member. If the renewal date has advanced, these case updates will be considered a case data change.
If renewals are not processed and completed, cases will appear on the COVID lock-in report and be considered out of compliance by federal and state policy as:
● Failed to complete the renewal process or
● Failed to return signature for renewal or
● Failed to provide verification
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Child Health Plan Plus (CHP+) Enrollment Fee Discontinued
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In an effort to remove barriers for families seeking health coverage, the Department of Health Care Policy & Financing (HCPF) and the Colorado General Assembly championed a health care bill that also included an amendment to eliminate the CHP+ enrollment fee at intake and renewal.
Effective July 1, 2022, the enrollment fee will no longer be required at intake for the CHP+ program. The CBMS project build date for this system change is June 11, 2022.
Please be advised, the requirement to collect an annual enrollment fee for CHP+ at renewal is currently suspended due to the Public Health Emergency (PHE) and will be permanently discontinued at the end of the PHE.
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The Department is implementing a statewide Medicaid electronic consultation platform called the eConsult Platform. This platform will promote the Department's mission to improve health care equity, access and outcomes for the people we serve.
The eConsult platform will enable communications between Primary Care Medical Providers (PCMPs) and specialists. The PCMP will be able to transmit clinical questions and medical information to a specialist, so the specialist can review the case without an in-person office visit with the member. The specialist and PCMP work together in the diagnosis and/or management of the member’s health care needs, or facilitate office visits with the specialist when clinically appropriate.
The Department expects to have an eConsult Vendor selected by this fall/winter.
Anticipated Timeline
- Mid-Spring/Summer 2022 - Invitation to Negotiate (ITN) Posted and Vendor Selection
- Fall/Winter 2022 - Contract Negotiations
- Winter 2023 – Centers for Medicare and Medicaid Services (CMS) Review of Contract
- Spring /Summer 2023 - Implementation Activities
- Summer /Fall 2023 - eConsult Platform Go Live
The timeline is subject to change without prior notice and is only provided as a reference.
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Medicaid Buy-In Program for Working Adults with Disabilities: Allowing individuals Ages 65 and Older to continue or enroll for benefits |
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As of July 1, 2022, there is no maximum age limit for Buy-In Program for Working Adults with Disabilities (WAwD).
Individuals must still meet all eligibility qualifications for the program. Working individuals must have a disability determination through Social Security or the state disability determination vendor, ARG. Individuals who are 65 and older who do not have a disability determination must submit a disability application to ARG.
To see more information, please view the resources below.
Resources:
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County Grants & County Incentives Program |
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County Incentives and Grants |
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County Incentives Programs
Final Reports for FY 2021-22 will be emailed to Directors and Secondary Directors after accounting completes the final payment. Please look for the Final Reports around the end of August.
Contracts for FY 2022-23 are in the process of being finalized. We thank counties involved in the conversations about the Customer Service Incentive for the feedback and robust discussion!
County Grants: Competitive
FY 2022-23 County Grants are in the process of being finalized. Once finalized, Project Summaries for counties awarded funding will be posted on the County Administration webpage.
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Timeliness for all Medical Assistance applications was measured at 97.91%. |
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Timeliness for all Medical Assistance redeterminations was measured at 98.44%. |
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Department Contacts & Resources |
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