This newsletter provides updates from the  Department of Health Care Policy & Financing (the Department) on implementation of House Bill (HB) 18-1136 and  is distributed periodically during the benefit development process .   

For more information about Substance Use Disorder (SUD) benefits, please email our team.

In upcoming newsletters, we will be highlighting information relevant to SUD providers that plan to offer residential and inpatient SUD services in Colorado through Medicaid funding. Information on enrollment with the Department and billing and coding information will be featured along with other important information about the new service coverage. Please look for this feature in upcoming SUD updates and newsletters.

RAE Communication

At this time, we encourage providers interested in receiving Medicaid reimbursement for residential and inpatient SUD treatment and withdrawal management services to reach out to the Regional Accountable Entities (RAEs) and Managed Service Organizations (MSOs) to discuss the credentialing and contracting process. Contact information for each RAE can be found on the Department's Accountable Care Collaborative Phase II webpage. Providers may choose to contact their local RAE or other RAEs throughout the state if they plan to serve populations state-wide. Please visit this webpage for MSO contact information. MSOs contract with providers to serve the non-Medicaid, indigent population in Colorado. Providers receiving Medicaid funding for residential SUD services will need to contract with RAEs to receive payment for treatment services and MSOs to receive payment for room and board cost associated with those stays.

ASAM Alignment and Training

Providers are also encouraged to acquaint, or reacquaint, their staff with the American Society of Addiction Medicine (ASAM) criteria. ASAM criteria will be utilized as the basis for the management of SUD benefits covered by Health First Colorado. Additionally, it is the foundation for the state's SUD treatment program licensure rules. The Colorado Office of Behavioral Health (OBH) is in the process of aligning its licensure rules more closely with ASAM criteria. Residential and inpatient providers are encouraged to review ASAM criteria and consider how their programs are aligned with the criteria in anticipation of licensure changes. Provider agencies should also ensure relevant staff are trained in the ASAM criteria. OBH partnered with Signal Behavioral Health to make ASAM training available at no cost for a limited number of staff in provider agencies. As of February, over 150 participants across the state have been registered in trainings. Training components #2 and #3 are scheduled to be offered in March. Providers are encouraged to enact plans to ensure that all staff needing ASAM training have completed relevant training by July 2020.

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