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Frequently Asked Questions
Can members with long-term care (LTC) have more time to complete the renewal process?
Yes, HCPF is leveraging guidance from CMS to extend the renewal period for people with LTC, waivered services and disabled buy-in members who have not returned their renewal packet or members who returned their renewal packet but its review has not been started by an eligibility site.
Instead of the 30-day delay CMS recommended, Colorado will be extending the renewal time frame for LTC members by 60 calendar days to allow for additional outreach and action on the renewal. This allows LTC members to have an additional 60 calendar days to return their packet or for it to be processed by the county for cases that are past due.
Do LTC members still need to complete, sign and return their renewal packets if a special extension is issued?
Yes, all members must complete, sign, and return their renewal packet to continue coverage, and they are encouraged to do so right away when it is their time to renew.
Special extensions allow extra time for more complex renewals; however, members may still risk losing coverage if renewals are not completed during the extended timeframe. Members must take action to maintain their coverage by submitting all the required information and documents.
How is Colorado responding to new guidance from the Centers for Medicare and Medicaid Services (CMS) for the ex parte process?
All states received guidance from CMS on August 30, 2023, that requires a change to the ex parte (automation) 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), as has been done in the past, CMS is requiring states to perform ex parte automation reviews on an individual basis, meaning each person in the household is reviewed and approved separately.
While this will increase automation and efficiencies over the long term, this new guidance will require significant changes to our eligibility system that will need to be completed through 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.
If a member with a September 2023 renewal date misses the deadline, will they lose coverage on September 30?
Members with a September renewal have until mid-October to return their packet without losing coverage while we implement a short-term fix for the ex parte process. If a member is determined to no longer be eligible for coverage during their renewal cycle, their coverage may end at the end of October. Members are strongly encouraged to complete, sign and return their renewal packet right away, not wait until the last minute.
What is the Good Faith Extension?
The Good Faith Extension is an agreement between the HCPF and counties to support all members going through the renewal process who indicate they are attempting to gather requested verifications and experiencing challenges and/or need additional time to gather documentation. County eligibility workers can use this extension to support members in taking additional time to submit the verifications and avoid an unnecessary termination.
Can a member return their renewal packet late?
Members can resume medical 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. In PEAK, an item was added to the To-Do List to indicate when a late medical assistance renewal can be submitted and processed without needing a new application. Members are encouraged to return renewal packets within 90 days if they miss the deadline rather than submitting new applications.
Can a member’s eligibility be backdated if they are disenrolled?
If a member is disenrolled for a procedural reason, they have a 90-day reconsideration period to submit their renewal packet. If they are determined to still be eligible during that 90-day period, coverage begins as of the 1st of the month they are determined eligible again.
If there is a gap in coverage, members must ask the county to be enrolled retroactively. If a member is determined no longer eligible, and they disagree with the decision, they can file an appeal.
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