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
November 1, 2016 -
November 3, 2016
8:30am - 4:00pm
Expanding Foundations Non-MAGI - Denver Metro
November 9, 2016 -
November 10, 2016
8:30am - 4:00pm
Expanding Foundations Long Term Care - Denver Metro
November 15, 2016 -
November 16, 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 October 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 |
Colorado interChange Postponement and Provider Revalidation Update - TIME SENSITIVE
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NOTICE: Colorado interChange postponed
Early this month, the Department announced the decision to postpone the Go Live date of the new Colorado interChange, provider web portal, member web portal and new Pharmacy Benefits Management System.
The new Go Live date is March 1, 2017.
Counties should continue to use their current processes for submitting claims, prior authorization requests and updates to the Department. Claims will continue to be processed and paid as they are currently.
The new Go Live date allows us to conduct more systems testing, better define system and business process changes and devote more time to working with our providers and county partners to ensure they are revalidated and enrolled in the Colorado interChange system.
County Revalidation and Enrollment
Counties must complete the revalidation and enrollment process to be approved as a Health First Colorado or CHP+ provider. Any county that bills the Department for services to our members, must complete the application.
Counties that have started the revalidation process should continue and submit their application as soon as possible. Counties that have not started the revalidation process should begin immediately. Counties not enrolled in the new Colorado interChange by March 1, 2017 will not be able to bill Health First Colorado (Colorado's Medicaid Program) or CHP+ for services.
Not sure how to get started? Check below to find your Provider Type. Then visit our website for
comprehensive instructions that will walk you through the application. If you run into any problems or have questions about the status of your application, you can call the Health First Colorado Enrollment and Revalidation Information Center at 1-844-235-2387 for assistance.
County agencies that reimburse for or provide
non-emergent medical transportation (NEMT), 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'.
For questions regarding the provider revalidation process, or to request assistance with your revalidation application, contact the Provider Questions Inbox.
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CBMS Communication 753 - Medical Assistance (MA) Project 9584 Go-Live Update
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Project 9584 Go-Live Update
CBMS Project 9584 - MA CBMS Updates - InterChange
The Department will be transitioning to a new claims system (the interChange) to replace the current claims system (MMIS) beginning on March 1, 2017. CBMS Project 9584 included all CBMS updates necessary to support the eligibility interface functionality including new data elements required for claims processing and reconciliation of eligibility data with the new interChange system that is required as part of this transition. This project was implemented September 18, 2016, with a go-live date of October 31, 2016.
To ensure that there is a seamless transition from MMIS to the interChange, the new interChange MA Eligibility Span process will go-live effective Monday, October 24, 2016, rather than Monday, October 31, 2016. The current MMIS MA Eligibility Span process will continue operating with no changes at this time.
Details:
Effective Monday, October 24, 2016 - CBMS will continue to send MA Eligibility Spans to MMIS and will also begin sending MA Eligibility Spans to the interChange for continued testing. This process will continue through February 2017.
Effective Wednesday, March 1, 2017, CBMS will no longer send MA Eligibility Spans to MMIS and will only send MA Eligibility Spans to the interChange.
From October 24, 2016 through February 28, 2017, MA Eligibility Spans will be populated/displayed within ALL eligibility span related pages in CBMS - Medical Assistance Eligibility Spans, View Medical Spans Summary, and Medical Spans Details. Effective March 1, 2017, MA Eligibility Spans will no longer continue to be populated/displayed within the View Medical Spans Summary and Medical Spans Details pages and will continue to be populated/displayed within the Medical Assistance Eligibility Spans page only.
The daily
Medical Assistance Eligibility Span Error Report will be available starting on Tuesday, October 25, 2016, and will be located within the Medical Span folder in Cognos.
Please continue to submit State Help Desk Tickets when issues are identified with MA Eligibility Spans.
For questions,contact the Medicaid Eligibility Inbox.
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CBMS Communication 751 - New Address for Dropping Off CHP+ Enrollment Fees and Buy-In Premium Payments
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New Addresses for CHP+ Enrollment Fees and Health First Colorado Medicaid Buy-In Premium Payments
New Address for Dropping off CHP+ Enrollment Fees
Starting on October 24, 2016, there will be a new address where members can pay their Child Health Plan Plus (CHP+) annual enrollment fee in-person. Beginning October 24, 2016, members should drop off their check or money order at 655 Bannock Street, Denver, Colorado 80204.
For the fastest processing, members can still pay online at
Colorado.gov/PEAK or mail their check or money order to P.O. Box 17548, Denver, CO 80217.
The member enrollment fee letter is scheduled to be updated to include the new in-person address for dropping off payments in spring 2017.
New Address for Dropping off Health First Colorado Medicaid Buy-In Premium Payments
Starting on October 24, 2016, there will be a new address where members can pay their Health First Colorado Medicaid Buy-In monthly premium in-person. Beginning October 24, 2016, members should drop off their check or money order at 655 Bannock Street, Denver, Colorado 80204.
For the fastest processing, members can still pay online at
Colorado.gov/PEAK or mail their check or money order to P.O. Box 5010, Denver, CO 80217.
The member premium letter is scheduled to be updated to include the new in-person address for dropping off payments in spring 2017.
For questions,contact the Medicaid Eligibility Inbox.
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Stakeholder Meeting Registration - County Dispute Resolution Process - TIME SENSITIVE
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Upcoming Stakeholder Meeting to Provide Feedback on Health First Colorado 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 on:
November 9, 2016
9:30 am - 11:30 am
Colorado Department of Health Care Policy and Financing 303 East 17th Avenue 11th Floor, Conference Room 11AB Denver, CO 80203
The webinar will be recorded and made available at a later date.
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Frequently Asked Questions - Retro Closing and Exceptions to 10 Day Noticing |
Retro Closing and Exceptions to 10 Day Noticing FAQs Now Available
Beginning on March 20, 2016, the Department implemented changes to the policy and logic in the Colorado Benefits Management System (CBMS) for retroactive or retro-closing and noticing for ongoing cases and redeterminations.
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Changes to parent or Caretaker Relative coverage - Webinar and FAQs |
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 hosted with PEAK Outreach and FAQs about this policy change. For information about changes to CBMS, see the Staff Development Center September build training.
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Updates to Colorado Benefits Management System (CBMS) and Colorado.gov/PEAK |
Several updates to CBMS and PEAK were implemented on October 16, 2016, to prepare for the upcoming open enrollment season.
Connect for Health Colorado/Medical Assistance Summary of Updates for October 2016:
C4HCO Annualized Social Security Income Update
Self-attested Social Security Actual Annual Income will be used for Advanced Premium Tax Credits (APTC)/Cost
Sharing Reductions (CSR) determinations rather than the annualized amount generated by the interface that
is used to verify social security income (BENDEX). This amount will display in PEAK and CBMS. CBMS users will
need to update the Actual Annual Income field if customers indicate that the actual amount is different than
the system generated amount.
C4HCO FDSH Receive and Transmit Interfaces
This project will create an interface between CBMS and the Federal Data Services Hub (FDSH) to verify information, including annual income, for households that include at least one member who is eligible for APTC/CSR. This verification is done in real time through Apply for Benefits (AFB) and certain reported changes through Report My Changes (RMC).
If C4HCO is unable to verify this information, the regular Verification Checklist (VCL) will be sent requesting that customers provide proof of their current annual household income within 90 days. If customers do not provide proof of their annual household income, they may lose APTC/CSR eligibility for failure to provide the requested documentation.
A new question will be added to the application asking, "Do you agree to allow Connect for Health Colorado to use income data, including information from tax returns?" If this question is answered with a "no," or is left blank, households will receive the standard VCL to provide proof of their annual household income.
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Timeliness for September 2016
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Timeliness numbers for the month of September 2016 are in!
Timeliness for all Medical Assistance
applications for the month was measured at
98.84 percent.
The Department and its county partners have registered 27 consecutive months above 95 percent timeliness.
Timeliness for all Medical Assistance redeterminations for the month was measured at
97.99 percent.
The Department and its county partners have registered 8 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 September 2016.
Applications
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Redeterminations
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Custer - 90.91% |
Baca - 91.96% |
Saguache - 94.94% |
Gilpin - 94.20% |
San Juan - 60.00% |
Gunnison - 81.90% |
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Kiowa - 82.61% |
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Moffat - 94.87% |
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Ouray - 92.41% |
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Saguache - 78.48% |
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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 Communications Updates |
Now Available: Health First Colorado Posters and Fact Cards!
In response to your requests for materials to help promote the new name for Colorado's Medicaid program, Health First Colorado, the Department now has the following materials, which we will be delivering them to you during scheduled county visits this fall.
- 11 x 17 and 24 x 36 posters announcing the new name (English and Spanish)
- Cards that highlight the top frequently asked questions about the new name
These printed materials are made possible thanks to generous funding from the Colorado Health Foundation. Please use these materials in your public areas to help promote Health First Colorado, and let your county liaisons know if you need additional materials.
If you have not yet updated your public-facing communications, including your website and printed materials as they are reprinted, please do so now! All references to Medicaid and Colorado Medicaid may be updated to Health First Colorado.
For more information on the Department's rebrand effort, contact Debbie Fimple, Health First Colorado Grant Manager.
Back to Top
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Wanted! Contact Information for County Websites |
Wanted: Contact information for your web content manager!
The Department would like contact information for the county staff person who manages your website content, so we can send him or her resources and news to more efficiently serve your population. Please send the name and contact information (email and phone) of the web content manger to Joel Risberg at:
joel.risberg@state.co.us.
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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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