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County Incentives Program
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| FY16-17 County Incentives Program Guidance |
Official guidance available below
In July 2016, the Department released formal guidance for county partners to successfully implement the FY 2016-17 County Incentives Program. Download the guidance by clicking below; it is also available on the
County Administration website.
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FY 2016-17 County Grant Program
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CFMS Coding
If your county was approved for County Grant Program funding for FY 2016-17, please ensure you use CFMS code M210.5400 to code all grant expenses.
Grant expenses should NOT be coded to county administration if the county was approved for Grant Program funding.
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| County Training Opportunities |
Staff Development Center:
Expanding Foundations MAGI - Denver Metro
October 4, 2016 -
October 6, 2016
8:30am - 4:00pm
Expanding Foundations Long Term Care - Denver Metro
October 5, 2016 -
October 6, 2016
8:30am - 4:00pm
Online through TrainColorado:
Building Effective Relationships
Civil Rights
Client ID State ID
Colorado Address Confidentiality Program
IRS 1095-B Health Coverage Video
Medicaid Buy-In
PEAK
Health App
Single Streamlined Applications (SSAp) 101
Understanding Poverty
Your Road to Resources
Department of Health Care Policy and Financing:
Annualized Income Webinar
Other training not mentioned above may qualify for the HCPF Training Incentive. Contact the County Relations team for more information on the Training Incentive.
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Quick Links and Resources
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Medicaid and CHP+ Rules and Guidance
Volume 8 - Rules - direct link to Secretary of State
HCPF Forms and Rules
HCPF Agency and Directors Letters
HCPF FAQs and Training
HCPF County Relations
CBMS Enhancement Sheets - Governor's Office of Information Technology (OIT)
Staff Development Center (SDC)
Training Calendar
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Welcome to the September 2016 edition of County Connections!
The content in this newsletter is designed to inform county directors, management and staff in areas such as county performance, process improvement, collaboration, policy updates, upcoming due dates and more.
The content will continue to evolve. We encourage our county partners to give us your content suggestions. Feedback can be sent to the
HCPF County Relations team.
Please feel free to share
County Connections
with your colleagues by selecting
forward this email
at the bottom of this page.
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Breaking News - Policy and Process Updates |
Provider Revalidation for County Agencies -
TIME SENSITIVE
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County agencies must revalidate in order to bill for services after October 31, 2016
Reminder: All Health First Colorado (Colorado's Medicaid program) and Child Health Plan Plus (CHP+) providers should have already begun the process for enrolling/revalidating providers and sites into the new Medicaid Management Information System, the Colorado interChange.
Please be aware that these requirements extend to county agencies that also provide services as a Health First Colorado or CHP+ provider.
County agencies that reimburse for or provides
non-emergent medical transportation (NEMT), they must enroll or revalidate as:
- Enrollment Type: Atypical
- Provider Type: 73 - Transportation
- Specialty Code: Non-emergency medical (525)
A county that is also an
emergency ambulance provider must enroll or revalidate as:
- Enrollment Type: Facility
- Provider Type: 13- Transportation
- Specialty Code Options:
- County Agency, Non Metro Area (124)
A county that is also a Children's Habilitation Residential Program (CHRP) case management provider must enroll or revalidate as:
- Enrollment Type: Atypical
- Provider Type: 11 - Case Manager
- Specialty Code: 330
Each business location must complete a separate application
A county that also provides services as a
Home and Community Based Services (HCBS) direct services provider must enroll or revalidate as:
A county that also provides services
only as an
HCBS case management agency must enroll or revalidate as:
- Enrollment Type: Atypical
- Provider Type: 11 - Case Manager
- Specialty Code: 330
Each business location must complete a separate application
A county that also provides services as a
Clinic must enroll or revalidate as:
- Enrollment Type: Group
- Provider Type: 16 - Clinic - Practitioner
There is not a provider type called "Local Public Health Agency." LPHA's should use the provider type 'Clinic - practitioner'.
The organization must be revalidated first. For the group application process to be completed, an Individual within a Group application must subsequently be submitted for the supervising MD/DO/NP. If your LPHA is led by an RN and is not affiliated with a qualified MD/DO/NP, the RN must check the "Certified Health Agency" box on his/her application (Individual within a Group) to waive this requirement. You will also need to submit applications for any other providers who bill Medicaid.
Why do providers need to enroll in the Colorado interChange?
Providers need to enroll in the Colorado interChange to continue providing goods and services to Health First Colorado members when the new system goes live on October 31, 2016. By enrolling in interChange, providers also accomplish the following:
- Revalidation and screening - New federal rules require providers to be revalidated/screened in accordance with the Affordable Care Act, section 6401 (a). The Online Provider Enrollment tool was built with this requirement in mind. It securely captures required information during enrollment and will allow providers to meet future revalidation requirements with ease.
- After enrollment, approved providers will be able to update and maintain their information online as well as managing affiliations, addresses, and indicating whether they are accepting new Health First Colorado members.
- Access to the new Provider Portal for claims submission, messaging, reporting, and checking member eligibility.
What happens if a provider does not enroll or revalidate into the Colorado interChange and receive their approval by October 31, 2016?
Starting October 31, 2016, providers that are not enrolled in the Colorado interChange will not be able to submit claims or PARs, receive payments, or verify member eligibility.
Bottom line - if providers are not
enrolled in the interChange, they no longer have an active Provider Participation Agreement with the Department and are no longer a Health First Colorado or CHP+ provider.
Providers can always enroll after October 31, 2016, but they will be considered a new provider and we cannot guarantee payments for items or services provided during a lapse in their Provider Participation Agreement.
For more information, visit Colorado.gov/HCPF/Provider-Resources or contact the Provider Questions Inbox.
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Provider Web Portal - Training Sessions for County Users - TIME SENSITIVE
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Web Portal Training Registration for County Agency Users
Are you a county agency that bills for services provided for Health First Colorado and CHP+ members? Training resources are now available!
Training for the new web portal begins Monday, October 3. These training are web based for your convenience. You can attend live web training sessions Monday through Thursday. You will also be able to access recorded versions of the trainings beginning October 13.
Please follow the instructions for registration and make sure you know which trainings are required for you.
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| Stakeholder Meeting - County Dispute Resolution Conference Process |
SAVE THE DATE - Upcoming Stakeholder Meeting to Provide Feedback on County Dispute Resolution Process
As part of the implementation of House Bill 16-1277, the Department is convening a stakeholder meeting led by the Department's LEAN experts to solicit feedback from county and community partners on proposed guidelines for the county dispute resolution process for eligibility determinations.
The meeting will be held at HCPF at 303 E. 17th Ave., Denver, CO 80203
11th Floor, Conference Room TBA
Wednesday, November 9, 2016: 9:30am - 11:30am
In-person and webinar options for attendance will be provided, and the webinar will be recorded. Registration information will be sent out in early October in a separate communication.
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| Changes to parent or Caretaker Relative coverage |
Department implements federal requirement
Beginning October 1, 2016, the Department is implementing a federal requirement that certain parents or caretaker relatives living with a dependent child under the age of 19 are required to enroll the child in qualifying health coverage, called minimum essential coverage, for the parent or caretaker relatives to be eligible for Health First Colorado (Colorado's Medicaid Program).
For more information, check out our webinar about this policy change. For CBMS information on this change, see the September 2016 Staff Development Center Build Training.
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| Updates to Colorado Benefits Management System (CBMS) and Colorado.gov/PEAK |
September 2016 Enhancement Sheets now available
Several updates to CBMS and PEAK were implemented on September 18, 2016, to improve the overall eligibility partner and consumer experience.
Medical Assistance Updates for September 2016:
CBMS Updates - interChange - CBMS users will access a new CBMS page to view the member's Medical Assistance Eligibility Span Summary and Details. In addition, a new Cognos report will display errors with MA Eligibility Spans that will require user intervention to correct any data entry discrepancies.
Incarceration Updates - Updates to Living Arrangement Values and Client Correspondence.
MAGI Updates to CHP+, Parent/Caretaker and Work Study Incomes - Updates MAGI Adult to check for minimum essential coverage for any dependents; updates PEAK question to capture work-study income; modifies the pend logic for those who do not provide Social Security Number verification or whose Citizenship Status is Unknown.
For more information on all CBMS updates for September 2016, check out the September 2016 Enhancements online.
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Timeliness for August 2016
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Timeliness numbers for the month of August 2016 are in!
Timeliness for all Medical Assistance
applications for the month was measured at
98.77 percent.
The Department and its county partners have registered 26 consecutive months above 95 percent timeliness.
Timeliness for all Medical Assistance redeterminations for the month was measured at
96.69 percent.
The Department and its county partners have registered 7 consecutive months above 95 percent timeliness.
This could not have been accomplished without the hard work of our county partners. Many thanks!
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The following counties were
below the 95.00 percent benchmark for the month of August 2016.
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Applications
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Redeterminations
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| Archuleta - 91.49% |
Archuleta - 94.85% |
| Dolores - 80.00% |
Chaffee - 92.72% |
| Moffat - 93.48% |
Crowley - 87.08% |
| Rio Blanco - 92.68% |
Gunnison - 82.07% |
| Saguache - 89.23% |
Hinsdale - 93.75% |
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Kiowa - 83.33% |
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Otero - 89.25% |
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Park - 93.84% |
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Pitkin - 94.04% |
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Saguache - 68.18% |
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San Juan - 86.36% |
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San Miguel - 93.81% |
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Medicaid Eligibility Quality Improvement Plan (MEQIP)
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MEQIP Reminders
A reminder to our county partners: the Quarter 1 MEQIP Report, covering review period July, August, and September of 2016,
is due on November 1, 2016.
As part of the FY 2016-17 County Incentives Program, the Department will be monitoring accurate authorization rates reported on each county's MEQIP Report. In order to earn Incentives funds through the MEQIP Incentive, the county must report a
90% or greater accurate authorization rate over the entire review period.
Also, please ensure you are sending all MEQIP Reports and documentation to the
MEQIP Inbox, instead of the program manager directly.
Frequently Asked Questions (FAQs) and further guidance on the MEQIP and other Incentives can be found in the FY 2016-17 County Incentives Program Guide, found on the
County Administration website.
For more information on MEQIP, contact Gina Martinez, MEQIP Program Manager.
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Process Improvement and Collaboration
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| Health First Colorado (Colorado's Medicaid Program) - County Website Updates |
County websites still requiring updates
As of June 27, 2016, the Colorado Medicaid program is now called Health First Colorado. The new name reflects the significant improvements that have been made to modernize Colorado's Medicaid program to better engage members and improve the quality and coordination of care.
The Department has monitored county human/social services websites to determine if the name change has occurred.
If your county is listed below, your county website has been successfully updated with references to Health First Colorado.
If your county is not listed below, please ensure that all references to Medicaid or Colorado Medicaid on your county's website are updated to Health First Colorado.
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Boulder County
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Eagle County
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Garfield County
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Mesa County
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Pitkin County
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Summit County
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Visit
Garfield County's website for a great example of how they used the online banner advertisements to promote the name change and information about the Health First Colorado program.
For more information on the Department's rebrand effort, contact Debbie Fimple, Health First Colorado Grant Manager.
Back to Top
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Cross-Agency Effort to Improve Member Eligibility Correspondence
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In spring 2016, the Departments of Health Care Policy & Financing and Human Services, the Governor's Office of Information Technology and Connect for Health Colorado partnered on a research project to inform and improve member eligibility correspondence.
The first part of the research project engaged our partners, members and communications experts in the field of plain language. We chose to focus on the four letters that would reach nearly every member: the Notice of Action, Redetermination/Renewal Letter, Income and Eligibility Verification System Letter, and Verification Checklist Letter.
The final reports, recommendations and a brief webinar to review the first part of the research project's findings are available at Colorado.gov/HCPF/PlainLanguage.
We are now beginning the next phase of work to get additional feedback from policy and legal experts, stakeholders and counties on the redrafted correspondence. We look forward to sharing additional information with you in the coming months our progress.
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| Building Better Health Conference |
- Training on the health coverage application process and marketplace plan selection
- Access to the latest uninsured data and coverage resources
- Networking time with other health coverage guides, assistance site navigators, certified application assistants, brokers, community-based organizations and advocates
Building Better Health
October 13-14, 2016
Crowne Plaza DIA
15500 E 40th Avenue
Denver, CO 80239
This statewide health coverage open enrollment kick-off event is hosted by the Colorado Health Foundation in partnership with Colorado Covering Kids and Families, the Colorado Department of Health Care Policy and Financing, the Colorado Consumer Health Initiative, the Colorado Division of Insurance, Connect for Health Colorado and PEAK Outreach.
Register today to join your colleagues and prepare for the 2017 open enrollment period.
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From Covering Kids and Families
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Desk Aid for Immigration Statuses Eligibility for Health Insurance Programs
Colorado Covering Kids and Families, working with the Department and Connect for Health Colorado, has created a job aid to assist eligibility and community-based workers with immigration statuses and eligibility. This job aid explains immigration eligibility guidelines according to immigration status/category and class codes for Health First Colorado (Colorado's Medicaid Program), Child Health Plan Plus (CHP+), and qualified health plans with or without financial assistance through Connect for Health Colorado.
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The Colorado Department of Health Care Policy and Financing complies with applicable federal and state civil rights laws and does not discriminate on the basis of race, color, ethnic or national origin, ancestry, age, sex, gender, sexual orientation, gender identity and expression, religion, creed, political beliefs, or disability. Learn more about our Nondiscrimination Policy.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-221-3943 (State Relay: 711).
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1-800-221-3943 (State Relay: 711).
For further information about this policy, to request free disability and/or language aids and services, or to file a discrimination complaint, contact:
504/ADA Coordinator
1570 Grant St
Denver, CO 80203
Phone: 303-866-6010, Fax: 303-866-2828, State Relay: 711
Civil rights complaints can also be filed with the U.S. Department of Health and Human Services Office for Civil Rights electronically through the
Office for Civil Rights Complaint Portal
or by mail, phone, or fax at:
1961 Stout Street Room 08-148
Denver, CO 80294
Telephone: 800-368-1019, Fax: 202-619-3818, TDD: 800-537-7697
Complaint forms are available online
.
For more information, please visit our website at
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