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

This newsletter is published monthly while the legislature is in session, and quarterly outside of the legislative session. The next edition will be published in April 2019. 

Please continue to direct any questions or constituent issues to the Department's legislative team:  
HCPF's 2019 Legislative Agenda

The 2019 legislative session convened on January 4, 2019. A brief overview of the Department's legislative agenda is on the Department's website. This year, our agenda bills focus on:  
  • Extending the Breast and Cervical Cancer Prevention and Treatment Program
  • Colorado Dental Health Care Program for Low-Income Seniors
  • Expanded Access to the Civil Monetary Penalty (CMP) Cash Fund
The Department also supports the following bills:
  • Hospital Transparency (HB19-1001)
  • Proposal for Affordable Health Care Option (HB19-1004)
  • Dental Services for Pregnant Women Enrolled in CHP+ (HB19-1038)
  • Lieutenant Governor Concurrent State Services (HB19-1127)
  • Prohibit Conversion Therapy for a Minor (HB19-1129)
  • Import Prescription Drugs From Canada (SB19-005)
  • Sunset In-home Support Services Program (SB19-164)
  • Behavioral Health Supports for High-risk Families (HB19-1193)
HCPF FY2019-20 Budget Agenda

A summary of the Department's discretionary budget requests submitted for consideration to the Colorado General Assembly, as part of the Governor's FY201 9 - 20  budget, is now available . These requests focus on improving customer service, program oversight and compliance, as well as supporting innovation.
Hospital Transformation Program

The Hospital Transformation Program (HTP) is a five-year reform initiative that builds upon the existing hospital supplemental payment program to incorporate value-based purchasing strategies into existing hospital quality and payment improvement initiatives. Over time,  hospitals across the state will be required to demonstrate meaningful community engagement and improvements in health outcomes  in order to  receive supplemental payments. The program will outline expectations for key activities and tracking measures,  in order to  establish statewide uniformity while providing the hospitals the flexibility to work with their communities on the best interventions and approaches.

Specific information about the program, as well as the timeline for implementation and hospital requirements, can be found in the HTP Concept Paper or the Hospital Transformation Program website. 

How Will the HTP Impact My County and Constituents?

Collaboration between hospitals and other health providers is at the heart of the program. Currently, hospitals are conducting a formal community and health neighborhood engagement process  in order to  understand the needs and resources in the community and identify and prioritize opportunities for the HTP. Ultimately, the program aims to improve patient outcomes through care redesign and integration of care across settings; improve the performance of the delivery system by ensuring appropriate care in appropriate settings; lower Health First Colorado (Colorado's Medicaid Program) costs through reductions in avoidable hospital utilization; and increase effectiveness and efficiency in care delivery. Hospitals in your district are tasked with transforming care across the six priority areas: care coordination and care transitions; complex care management for targeted populations; behavioral health and substance use disorder coordination; perinatal care and improved birth outcomes; recognizing and addressing social determinants; and reduce total cost of care.

If you have additional questions about the HTP, please contact Courtney A. Ronner, Hospital Relations and Communication Manager, at 303-866-2699 or [email protected]
House Bill 18-1136 Update

The Department continues to prepare for submission of an 1115 waiver for inpatient and residential substance use disorder  (SUD)  benefit. In order to  move the project forward efficiently, the Department is in the process of finalizing contracts for services including waiver application writing, stakeholder engagement assistance and SUD treatment provider mapping. The Department's rate analytics team has begun collaboration with O ffice of  B ehavioral  H ealth  to gather information needed for the task of rate setting. Additionally, HCPF staff devoted to this project are in the process of comparing provider qualifications to national standards, as required by  the  C enters for  M edicare and Medicaid  S ervices  for the waiver.
Senate Bill 266 Update

Under Senate Bill 18-266 Controlling Medicaid Costs, the Department is charged with implementing an evidence-based Inpatient Hospital Review Program (IHRP) to ensure that the utilization of hospital services is based on a recipient's need for care. Additional information regarding the Controlling Medicaid Costs Initiatives can be found on the Department's website. 

The Department has expanded its partnership with the Utilization Management (UM) Vendor, eQHealth Solutions, Inc, which already supports Prior Authorization Requests (PARs) for select outpatient and surgical procedures. Training on the use of eQSuite®, and the new IHRP is now available on the Colorado Provider website, and a Question and Answer document has been posted to the website to provide additional information.

The Cost Control and Quality Improvement office continues to engage
hospitals in an effort to ease the IHRP implementation for providers and members. This has included: 
  • Addressing individual questions and concerns from hospitals
  • Convening one-on-one technology meetings between hospitals and eQHealth
  • Holding a joint operating meeting with the Colorado Hospital Association and member hospitals
  • Hosting a meeting between hospitals and Regional Accountable Entities regarding the data transfer that will facilitate transition planning and care coordination for members
Stakeholder feedback has been overwhelmingly positive to date.

T he IHRP  is effective  March 18, 2019. Providers will begin submitting reviews to eQHealth Solutions.  To allow for a period of transition, reviews will be required for payment processing as of May 15, 2019.  
HCPF Submits New Reports & LRFIs to the General Assembly

HCPF submitted many new reports and LRFIs to the General Assembly over the past month, all are on the Legislator Resource Center page.
Medicaid Snapshot and County-by-County Resources

The County Fact Sheets have been updated for FY2017-18 and will continue to be updated when new data is available. These fact sheets provide an annual snapshot by fiscal year for Health First Colorado (Colorado's Medicaid Program) activity including average annual caseload and top five claim types for each county. 
Legislator Resource Center

The  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 to help inform legislators.
Follow HCPF on Social Media

We invite legislators to 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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