Provider Association Newsletter
August 2019
Welcome to the Department of Health Care Policy & Financing (the Department) newsletter for health care leaders. This newsletter  is  published  quarterly,  and we hope to focus on topics that provide additional support and information to you - our partners.   
If you would like to provide feedback on the topics this newsletter addresses, please share your thoughts through this survey.    
Message from the Executive Director
Over the past five years, t he Department has implemented multiple initiatives to combat overprescribing and excess opioid utilization within Health First Colorado. These initiatives, along with provider education and heightened public awareness of the opioid crises, have resulted in a more than 50 percent reduction in the number of opioid units dispensed to Health First Colorado members and a 44 percent reduction in the number of members using opioids from January 2014 - December 2018.
Some of our Department initiatives over the past five years include:
  • Tightened criteria on short-acting opioids and added quantity limits
  • A pain resource webpage with information on opioid use/misuse, pain assessment guides, risk assessment tools and methods to reduce opioid use safely and effectively 
  • A Chronic Pain Disease Management Program to help train providers in appropriate use of opioids
  • Limiting initial prescription fills to a 7-day supply and limiting the member to two refills
  • Reducing the daily maximum dose from 300 MME/day to 200 MME/day
  • Implementing a dental opioid policy limiting members to three four-day prescription fills
Our press release details information on our initiatives, which includes a year-by-year evolution of our opioid policy intended to combat addiction and opioid overprescribing. In 2020, the Department will launch a tool for all providers to help them reduce the chances of addiction among their patient populations. The tool is being designed in collaboration with physician groups, insurance carriers and stakeholders.
Together, we are tackling excess opioid utilization, which is protecting our members from the devastating consequences of addiction while ensuring access to proper pain management therapy. Thank you for your partnership as we work to make Colorado the healthiest state in the nation.
Kim Bimestefer
Dr. Tracy Johnson Named Colorado's  Medicaid Director
Tracy Johnson, Ph.D. will join the Department as Colorado's Medicaid Director. Johnson will oversee the Department's Health Programs Office, which administers public health insurance programs for Coloradans including Health First Colorado (Colorado's Medicaid Program) and Child Health Plan Plus (CHP+). Laurel Karabatsos has served as Interim Medicaid Director for the last several months and will fill the Deputy Medicaid Director role upon Johnson's start date. Read our news release to learn more. 
Bonnie Silva Named Office of Community Living Director
Bonnie Silva has been selected as the Department's Director  of the Office of Community Living (OCL). Bonnie brings a wealth of experience, insights, expertise and passion to this key role within the Department. Read our news release to learn more.
Hospital Transformation Program
Update on HTP timeline

In June, the Department informed stakeholders of the transition to a State Plan Amendment (SPA) for the initial implementation of the developed Hospital Transformation Program (HTP) components. Since then, many stakeholders have reached out to Department staff with questions about the timing of outstanding program components. In order to answer these questions, we have created a document outlining the tasks and program design components remaining before the SPA and Section 1115 waiver can be submitted to The Centers for Medicare & Medicaid Services (CMS). This document can be found on the HTP website.

Update on HTP Stakeholder Engagement Forum

As reported in the last HTP Newsletter, the Department will host multiple HTP Stakeholder Engagement Forums to give all those involved in the program an opportunity to provide feedback to the Colorado Healthcare Affordability and Sustainability Enterprise (CHASE) Board and Department staff. Thank you for all of your responses to the HTP Stakeholder Engagement Survey we shared. Currently, we are working to identify a facilitator and will begin hosting meetings in the fall. Updates about the forum can be found in future HTP Newsletters. Stay tuned!

Community & Health Neighborhood Engagement Final Report

Final reports for the Community & Health Neighborhood Engagement (CHNE) process are due Sept. 20, 2019. The final report template and final report review criteria document can be found on the HTP website. Final reports must be submitted in PDF format by 5 pm Sept. 20, 2019 to the HTP email address. Reports received after this deadline will not be considered. Following the submission date, the reports will be reviewed by an independent analyst. The reports will not be scored and the Department will work collaboratively with participants as they work on their applications to address any questions or concerns that may arise from the final report.
In preparation for the final report submissions, the Department will hold virtual office hours to go over the report template and review criteria, as well as answer any questions stakeholders have. Virtual office hours will be held from 3 to 4 pm MT Tuesday, Aug. 20 and Thursday, Aug. 22. Additional information can be found in a special alert sent to stakeholders.

If you'd like to know more about the HTP, we encourage you to visit the HTP website and read past editions of the HTP Newsletter in our online archives If you have additional questions about the HTP, please contact Hospital Relations and Communication Manager Courtney A. Ronner at 303-866-2699.
Vendor Switch for Colorado Child Health Plan Plus (CHP+) Dental Billing
Effective July 1, 2019, DentaQuest took over administration of the CHP+ dental program from Delta Dental. DentaQuest is the current administrator for the Health First Colorado (Colorado Medicaid program) dental benefit. DentaQuest invites providers to join their network caring for the children enrolled in CHP+.  
Contact the recruitment department toll-free at 855-873-1283 or email for additional information .
State Innovation Model
Free Resources for Health Care Teams

The Colorado State Innovation Model (SIM), which worked with 25 percent of the state's primary care practices and four community health centers during a four-year time frame, ended July 31. While the federally-funded Governor's office initiative has concluded, resources created with SIM funding will be available to all providers free of charge through the SIM website, which will be maintained as an archive for one year.
Continuing the Push Toward Integrated Care

SIM improved patient access to integrated behavioral and physical health in primary care settings -- but the work is not done. As SIM concludes, industry partners are committed to maintaining momentum. Join the Colorado Is Ready LinkedIn group to share your experience, support a new network and identify next steps together. The conversation started Aug. 1. Make sure your voice is heard. #coloradoisready
Updates on Proposal for Affordable Coverage Option HB19-1004 Implementation
The Department and the Colorado Division of Insurance held introductory stakeholder meetings in late May and early June around the implementation of the Proposal for Affordable Health Coverage Option (HB19-1004). The bill requires the Department and the Division of Insurance to develop and submit a proposal to the General Assembly by Nov. 15, 2019, concerning the design, costs, benefits and implementation of a state option for health care coverage. 
Stakeholder meetings throughout the state are being planned for this summer to inform the proposal. Hear recordings of prior meetings, view presentations and find dates for upcoming meetings on
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