General Assembly Newsletter
Stay up-to-date on what's new at HCPF with this newsletter created specifically for the Colorado General Assembly. 

Please contact Zach Lynkiewicz if you have questions or need help with constituent issues. 
Director Birch is Leaving HCPF

Last month Governor Hickenlooper announced that Sue Birch will be leaving her role as Executive Director of the Department of Health Care Policy & Financing to become the Health Care Authority Director for Washington State. Director Birch has been with HCPF since January 2011 and, under her leadership, Colorado has consistently ranked among the top states in health system performance and long-term services and supporters on various national scorecards.

During her tenure, Director Birch oversaw the implementation of the Affordable Care Act (ACA), including the expansion of Health First Colorado.  Prior to the implementation of the ACA, Colorado's uninsured rate was 14.3 percent; it is now 6.5 percent.  She also oversaw changes to eligibility for public insurance programs, including the launch of the Medicaid Buy-In Programs for Working Adults with Disabilities and Children with Disabilities, as well as 12 months of continuous coverage for children enrolled in Health First Colorado.

Other milestones of Director Birch's time at HCPF include the addition of an adult dental benefit, tighter opioid prescribing and dispensing policies and improvements to the way care is delivered to more than a million Coloradans through the Accountable Care Collaborative.

Director Birch will leave her position this Friday, November 17. Former Representative and current Deputy Executive Director Tom Massey has been named by the Governor as the interim director. 
Children's Health Insurance Program Update

Federal funding for the Children's Health Insurance Program, known in Colorado as Child Health Plan Plus, or CHP+, has ended.  There are two bills currently being considered by Congress that could extend the program for another 5 years but, to date, neither has passed. Congress can act at any time to renew the federal funding for the program but there is no guarantee they will.

If Congress does not act, CHP+ in Colorado will end January 31, 2018. At this time, there are no changes to CHP+ eligibility, enrollment, renewals, or benefits.

Approximately 75,000 Colorado kids and pregnant women will lose their health care coverage if CHP+ ends. Many may qualify for financial assistance to purchase private health insurance through Connect for Health Colorado, some may be eligible for Health First Colorado (Colorado's Medicaid Program), and some will not qualify for financial assistance or Health First Colorado. A county-by-county breakdown of CHP+ members and other important information about the CHP+ program is available on our website.

The Department has been working closely with Connect for Health Colorado, CHP+ health plans, stakeholders, counties, eligibility partners, providers and the Member Experience Advisory Council to develop communications and guidance about the possible end to CHP+, including webinars, FAQs, talking points and other resources. We are collaborating with these partners to also write letters for members that will help them understand what is happening with the CHP+ program. The first of these letters is scheduled to be mailed the last week of November if Congress does not act by November 17, 2017. If Congress does not act by mid-December, a second letter will be sent at the end of December officially notifying members of the program's end on January 31, 2018 and explaining to them what coverage options they may qualify for.

Visit CO.gov/HCPF/FutureCHP for the most up-to-date information about CHP+ in Colorado and links to resources for stakeholders, counties, eligibility partners, and providers. Feel free to share these resources with anyone interested in the status of CHP+ in Colorado.
HCPF FY2018-19 Budget Agenda

A summary of the Department's discretionary budget requests submitted to the Colorado General Assembly for consideration as part of the Governor's FY2018-19 budget is now posted on our website .  These requests focus on ensuring program compliance, achieving cost savings and targeted program improvements supporting member experience.  In total, these requests are budget negative and, in many cases, reduce General Fund expenditure in FY2018-19. 
Medicaid Claims Payment System Update

Colorado launched the Colorado interChange, a new claims payment system and fiscal agent service, on March 1, 2017. Since Go Live, the Colorado interChange has processed more than 35 million claims and paid $5.5 billion to providers.

There are currently 52,937 providers enrolled as Colorado Medicaid providers. Providers continue to enroll every day.

Currently, the Colorado interChange and Fiscal Agent operations are in an Implementation phase. Although we are able to be proactive with systems updates, we are still in a space where we have to be reactive to issues brought to our attention by providers. We have made significant improvements between the March 1st Go Live and today. This progress will continue as time goes on until we get to Normal Operations.

The Department is doing a lot of work to get to Normal Operations.
  • Increased provider outreach. Executive leadership and policy and rates subject matter experts are touring the state to meet with providers and hear their concerns. Over the past few weeks the Department has visited rural hospitals and in coming weeks we'll be partnering with our Regional Care Collaborative Organizations (RCCOs) to attend regional provider meetings. The Department is also hosting regular meetings with provider associations to review their members' list of remaining issues.
  • Improving call center quality. The Department is closely partnering with DXC Technology (DXC) to achieve first call resolution at the Provider Services Call Center. Department subject matter experts are providing increased training and support to agents at the call center and are implementing additional quality control.
  • Streamlining processes to better serve our providers. As we move towards Normal Operations, there are opportunities to enhance the system to be more in line with what providers want. An example of this is the format of the Remittance Advice (RA) which has been a common complaint from providers. The RA, technically, provides the necessary information but we acknowledge that it can be confusing and burdensome, so the Department is working to make improvements to the document.
As a reminder, the Department frequently updates its Known Issues and Updates web page. There is also an archive of presentations, fact sheets and other handouts on our Legislator Resource Center web page.
Co-Pay Increase Implementation Update

SB17-267 directed the Department to increase Medicaid co-payments for pharmacy and hospital outpatient services. The Department is anticipating increasing the co-pays on impacted services on January 1, 2018 in accordance with the legislation.  The Department is working with impacted provider groups and client advocates to ensure smooth implementation. Additional information will be made available in the January legislator newsletter.
Accountable Care Collaborative Phase II: Protest Period 

In early October, the Department made initial awards for seven Regional Accountable Entities (RAEs) for the next iteration of the Accountable Care Collaborative (ACC). However, the Department has received formal protests on the contract awards. In accordance with State procurement rules, during the protest period the Department is prohibited from discussing the solicitation, contract awards and negotiations until all protests and appeals are resolved. The Department is continuing to prepare for the implementation of the next phase of the ACC. Below are m ajor implementation milestones.

HCPF Submits New Reports & LRFIs to the General Assembly

HCPF submitted thirteen reports and LRFIs to the General Assembly over the past quarter. They focus on a variety of topics, including the Department's Medicaid provider rate review recommendations, improving Medicaid fraud prosecution and regional center task force recommendations.
Recent Articles of Interest
Legislator Resource Center

As a reminder, our Legislator Resource Center  on our website is available to help legislators and legislative staff easily find information. It includes links to reports, fact sheets and overviews of the budget process.  We hope you find them helpful and informative.
Follow HCPF on Social Media

We hope you will follow us on social media to stay informed of news and happenings at the Department.  You can follow us on Facebook , Twitter and LinkedIn
Colorado Department of Health Care Policy & Financing  
(303) 866-2993 | 1570 Grant Street, Denver, CO 80203
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