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.
End-dating overdue pregnancy records timely will ensure all pregnant members receiving Health First Colorado or CHP+ receive the 12-month postpartum benefit per 42 CFR 435.170(c). If pregnancy records are not end-dated timely, this can result in incorrect eligibility determinations, an inaccurate postpartum period (per 42 CFR 435.170(c)), and inaccurate co-pay exemptions.
This memo communicates how Family Medical Leave Insurance Program (FAMLI) income is considered in determining eligibility for Adult Financial (AF), Colorado Works (CW), Supplemental Nutrition Assistance Program (SNAP), and Medical Assistance (MA) programs.
This memo provides information about the new Long-Term Services and Supports (LTSS) Streamline process that went into effect March 1, 2024. This memo outlines impact on PEAKPro and Colorado Benefits Management System (CBMS). This guidance is for anyone who works with Long-Term Care (LTC) and should be shared with Medicaid eligibility staff, supervisors, and outside agencies, as appropriate.
This memo informs counties of HCPF’s FY 2024-25 County Administration Allocation based on enhanced and non-enhanced Medicaid administration funding split.
FY 2024-25 HCPF County Administration Public Health Emergency (PHE) Allocation and Funding Guidance
This memo communicates information about the FY 2024-25 county administration appropriation for the COVID-19 Public Health Emergency (PHE). The appropriation is provided to counties to manage the conclusion of the Continuous Coverage workload resulting from the PHE. This Operational Memo provides guidance regarding funding and staffing relating to this appropriation.
This memo advises eligibility sites of the increase to the Community Spouse Minimum Monthly Maintenance Needs Allowance (MMMNA) and Shelter Allowance. Please share this letter with all eligibility staff, supervisors and administrators that manage nursing facilities, Home- and Community-Based Services (HCBS), the Program of All Inclusive Care for the Elderly (PACE) and other outside agencies as appropriate.
This memo provides partners with information about the new Long-Term Supports and Services (LTSS) Streamline process that is effective March 1, 2024. This memo outlines its impact on PEAKPro and Colorado Benefits Management System (CBMS). This guidance is for anyone who works with Long-Term Care (LTC) and should be shared with Medicaid eligibility staff, supervisors, and outside agencies, as appropriate.
Implementation of the FY 2023-24 Performance Compliance Incentive
This memo provides guidance to counties on how to operationalize the FY 2023-24 County Incentives Program Performance Compliance Incentive. The County Incentives Program creates performance-based benchmarks and deliverables for counties to achieve County Administration and Medical Assistance Eligibility performance standards. The Performance Compliance Incentives state the Contractor shall comply monthly with the MAP Dashboard performance measures as outlined in the County Incentives Program Contract and issued Operational Memos. The performance measures may include timeliness of applications/redeterminations, timeliness of long-term services and supports (LTSS) applications/redeterminations, timeliness of case changes, etc.
Implementation of the FY 2023-24 County Incentives Program Customer Service Incentive
This memo provides guidance to counties on how to operationalize the FY 2023-24 County Incentives Program Customer Service Incentive. The County Incentives Program creates performance-based benchmarks and deliverables for counties to ensure they achieve certain performance standards related to County Administration and Medical Assistance Eligibility.
This memo provides guidance to counties on how to operationalize the FY 2023-24 County Incentives Program Accuracy Incentive. The Accuracy Incentive was implemented for counties to reduce eligibility determination error rates to meet federal requirements and to ensure compliance with the Eligibility Quality Assurance (EQA) program requirements, case review findings and processes. The EQA program reviews eligibility determinations completed for new applications, redeterminations, and case changes.
This memo informs partners of the process to initiate and complete Medical Assistance Desk Reviews. Desk Reviews of Eligibility Sites ensure compliance with federal and state statute, HCPF rules, and sub-regulatory guidance. The purpose of these reviews is to evaluate and assess actions, policies and/or procedures of Eligibility Sites and for any instances of noncompliance to be addressed. This allows for improvements to be found and addressed locally prior to future audit findings.
Personnel Screening Requirements for Eligibility Staff
This memo informs County Departments of Human/Social Services and Medical Assistance and Eligibility Application Partner Sites (“Eligibility Sites”) of the obligation to conduct personnel screenings on staff to ensure compliance with federal regulations. Counties and eligibility sites must conduct criminal history background checks on staff who will have access to Colorado Benefits Management System (CBMS).
Health First Colorado Buy-in for working adults with disabilities 2024 income chart and premium guide
This memo advises partners of income changes to the Health First Colorado Buy-In Program for Working Adults with Disabilities (WAwD). Please share this information with anyone who works with this program.
Health First Colorado Children with disabilities buy-in 2024 income chart and premium guide
This memo advises partners of income changes to the Health First Colorado Buy–In Medicaid Program for Children with Disabilities (CBwD). Please share this memo with anyone who works with this program.
Medical Assistance Reapply function versus Rescinding
This document provides eligibility sites with guidance on when to use the Medical Assistance (MA) reapply function versus rescinding a case. Additionally, this document provides timeframes on when an applicant or member needs to resubmit a new application after being denied at application or terminated at ongoing or renewal. Data entry will not be covered in this document.
This memo notifies all partners of the income guidelines for the Modified Adjusted Gross Income (MAGI) Medicaid and Limited Family Planning Medical Assistance program, and the Child Health Plan Plus (CHP+) program, effective April 1, 2024.
Limited Authorized Representatives for Signing Applications or Renewals
This memo notifies partners of a change in the ability to select an authorized representative exclusively for signing an application or renewal for Health First Colorado.
This memo provides partners with information about the new Long-Term Supports and Services (LTSS) Streamline process that is effective on March 1, 2024. This memo will outline its impact on PEAKPro and Colorado Benefits Management System (CBMS). This guidance is for anyone who works with Long-Term Care (LTC) and should be shared with Medicaid eligibility staff, supervisors, and outside agencies, as appropriate.
Medical Assistance - Medicare Savings Program and Low-Income Subsidy
This memo advises eligibility sites of income limits for the Medicare Savings Program (MSP) and Low-Income Subsidy (LIS). MSP Categories include: Qualified Medicare Beneficiaries (QMB), Specified Low-income Medicare Beneficiaries (SLMB), Qualified Individuals (QI-1), and Qualified Disabled Working Individuals (QDWI). Please share this memo letter with anyone who works with these programs.
