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TopAt a Glance
April 30, 2019                                                                                  
In This Issue
Quick Links
In March 2019, there were 1,244,320 Coloradans enrolled in Health First Colorado and 81,996 enrolled in
Upcoming Events and Helpful Resources
Health First Colorado printed materials are available on our website
Health First Colorado videos for use in waiting rooms and other areas members visit are available for download on our website
New to PEAK or Need a Refresher?

The Intro to PEAK and Application Walk-Through recorded webinars are available anytime. For more information and trainings, visit the PEAK Outreach Initiative website.
Public Rule Review Opportunities

Anyone interested in a one-on-one discussion with Department staff about upcoming rules is invited to attend the Department's Public Rule Review Meeting. Information is available on the Public Rule Review Meetings web page. 

For more information, or to be added to the Medical Services Board email distribution list, please contact Chris Sykes.
Employment Opportunities

Applying for state government jobs is easy. Applications are electronic, you will receive updates, and you do not need to answer any written questions until it is determined that you meet the minimum qualifications. 

Check out the website for State of Colorado jobs including the Department of Health Care Policy and Financing jobs.
Welcome to the April 2019 edition of At a Glance!

At a Glance is a Department of Health Care Policy & Financing publication which provides information on major initiatives including policy changes and program updates. Please feel free to share At a Glance with your colleagues. Previous editions of At a Glance are available on our website.

Thank you for your interest!

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A Message from the Executive Director
A quality and affordable health care system is essential to building strong communities that thrive. That's a prime reason Coloradans are voicing their deep concerns over continued increases in health care costs. They're demanding that something be done now to cut costs while preserving quality.
 
In response, the Governor released  a new roadmap  that lays out his vision, including short-, medium- and long-term strategies to achieve the goal of saving people money on health care.
 
HCPF, other agencies and stakeholders are collaborating across many sectors of the industry to lower health care costs, and one of those sectors is Prescription Drugs. 
 
More to come next month.

Kim Bimestefer
Breaking News
Important Information About Denials for Secondary Aid Codes
Denial or Termination notices generated since February 2019 do not tell members denied or terminated from the Medical Assistance (MA) Secondary Aid Code that they remain eligible for the MA Primary Aid Code. The Primary Aid Code includes payment of the Medicare Part A and/or B Monthly Premiums except for the following aid codes that do not allow Medicare at the same time: MAGI-Adult, BCCP, BCCP-PE, or QDW. 

This is causing confusion for MA members which is resulting in an increase in contact to both the County DHS offices and HCPF along with an increase in Colorado Benefits Management System (CBMS) Help Desk Tickets.
 
A future CBMS project will update the MA Secondary Aid Code denial and termination Notice Of Action language to clearly explain that the denial or termination is only for the MA Secondary Aid Code, and that they remain eligible for the MA Primary Aid Code, which covers payment of the Medicare Part A and/or B monthly premiums.
 
Action needed : If you receive a call from a member, review the case and ask the member to provide the Additional Information Resource Packet (AIRP) and/or verifications. If you see the case is not being determined correctly please submit a help desk ticket. 

Legislative Update
January 4, 2019, marked the first day of the second session of the  72nd  General Assembly. Per the state Constitution, the Colorado legislature is in session no more than 120 days, adjourning this year on May 3 , 2019.

Department Legislation
The Department has three bills on its legislative agenda this session, including:
All of the bills have been introduced; details on each are on our website

For more information, contact David DeNovellis.
Tools for Transformation 
Hospital Transformation Program: Community & Health Neighborhood Engagement
The pre-waiver year of the Hospital Transformation Program (HTP) is dedicated to the Community and Health Neighborhood Engagement (CHNE) process and is seen as a cornerstone of the program. State-wide hospitals participating in the HTP are required to engage organizations that serve and represent the broad interests of the community, including clinical providers, to identify community needs and resources. The CHNE process is intended to build on the strong spirit of collaboration within Colorado's health system and efforts and partnerships already underway.
 
HTP participants are expected to engage, consult, and be informed by health neighborhoods and community organizations to identify community needs and inform the selection of transformation initiatives that address those needs during the planning process. Leveraging existing forums and collaborations will help to maximize community participation. Hospitals should align their engagement activities with advisory groups, existing programs and alliances, and statewide initiatives designed to strengthen the health care system.
 
Important CHNE dates:
  • November 30, 2018- Hospitals submitted their CHNE Action Plan to outline how they will conduct the CHNE process.
     
  • April 19, 2019- Midpoint Report due date. Hospitals reported on CHNE work over the first half of the pre-waiver process. A Midpoint Report template as well as Midpoint Report training is available on the HTP website. These reports will be made available to the public by request once the Department has completed its reviews and the reports are finalized around the middle to end of May 2019. We will send out a notification when those are available.
     
  • September 20, 2019- Final Report due date. Hospitals must submit a Final Report at the end of the pre-waiver CHNE process, which will include information about the entirety of the process but with a primary focus on their efforts to prioritize community needs, select target populations, identify initiatives, and develop any partnerships.
Those interested in e-updates about the HTP should sign-up through the HCPF website . To complete the sign-up process, enter your contact information and click the "Hospital Transformation Program" box. 

For more information, contact Courtney Ronner.  

Partnerships to Improve Population Health 
Dental Coverage for Child Health Plan Plus Moms
Governor Polis signed HB19-1038, Dental Services For Pregnant Women Covered Under The Children's Basic Health Plan Plus, into law. The Department will provide updates throughout the implementation process. 

Thank you to all of our partners and stakeholders who helped make dental coverage for CHP+ moms a reality.
       
Delivery Systems Innovation
Substance Use Disorder Benefit Update
The Department will host a series of stakeholder meetings during May and June. During the May meeting, staff will discuss waiver requirements that relate to the implementation of the benefit. These issues influence decision making about the benefit and will have the potential to impact the delivery of Substance Use Disorder (SUD) services beyond the proposed Health First Colorado benefit. 

In June, there will be three meetings which will focus on the benefit as it has been conceptualized at that time. Stakeholders will be invited to provide feedback on the proposed benefit and other general issues that relate to the waiver. The content of the three June meetings will be identical to one another; two meetings will be held in different Front Range locations and one meeting will be conducted as a Zoom meeting. To see additional information regarding these stakeholder meetings, please RSVP by May 8 .
 
Research on SUD Services
The Department continues to work closely with the Colorado Office of Behavioral Health (OBH) to map the availability of treatment providers at all care levels as well as Medication Assisted Treatment (MAT) providers. The Department is also examining how the existing network of SUD care in Colorado compares with CMS requirements, as well as to the American Society of Addiction Medicine (ASAM) criteria. Departmental staff have conducted research on how other states are managing a variety of waiver requirements including patient placement decision making and utilization management. The Department has gathered information about existing practices related to these issues from a variety of Colorado stakeholders.
 
For more information, sign up for our Substance Use Disorder Newsletter or contact Kim McConnell.

Accountable Care Collaborative Phase II Resources
The next iteration of the Accountable Care Collaborative (ACC) began July 1, 2018. As a reminder, the Department has published resources and guidance for providers, members, and other interested parties on CO.gov/HCPF/ACCPhase2.

Nondiscrimination Policy
The Colorado Department of Health Care Policy & 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.

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