In July 2018 there were 1,291,160 Coloradans enrolled in Health First Colorado (Colorado's Medicaid Program) and 83,180 enrolled in
(CHP+).
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Upcoming Events and Helpful Resources
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| 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.
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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.
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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.
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Welcome to the August 2018 edition of At a Glance!
Thank you for your interest!
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| Update from the Executive Director |
Governor John Hickenlooper recently signed "Controlling Medicaid Costs"
Senate Bill 18-266
into law. The bill, which passed the House and Senate with unanimous support, better enables the Department to control costs within Health First Colorado (Colorado's Medicaid Program) and Child Health Plans Plus (CHP+) and its other programs.
The bill has four main components:
- Creation of a program to review hospital admissions and improve member care coordination upon discharge
- Funding for innovative tools that support member care pathways based on quality and cost
- Additional safeguards to prevent inappropriate claim payments
- Funding for a new office in the Department which pursues cost control strategies, alternate payment methodologies, delivery system innovations, quality enhancements and other approaches to benefits for Health First Colorado and CHP+ members, consumers, employers and taxpayers
The implementation of this bill helps us better support and care for Coloradans when they are the sickest and most vulnerable while preparing for upcoming economic volatility and aligning Department programs with industry standards.
In the coming months, I'll be providing updates to you about this bill and other initiatives.
Thanks,
Kim Bimestefer
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| DATE CHANGE: Verification Checklist Webinar |
------------UPDATED WEBINAR DATE: October 11, 2018-------------
On October 15, 2018, the Colorado Benefits Management System (CBMS) will begin sending a new Verification Checklist (VCL). The new VCL's language and layout has been updated for improved readability. The Department worked in collaboration with the Colorado Department of Human Services, Connect for Health Colorado and stakeholders throughout the process. The new VCL was also consumer tested in English and Spanish and edited to incorporate feedback.
Join the Department for a webinar on the new VCL. This webinar will be offered twice with the same content. Space is limited, and the recording will be available online after the live sessions.
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Delivery Systems Innovation
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| Supported Living Services Waiver Update |
Consumer-Directed Attendant Support Services (CDASS) are now an available service delivery option through the Home and Community-Based Services Supported Living Services (HCBS-SLS) waiver. Please see our
Department memo for more information.
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| Accountable Care Collaborative Phase II Resources |
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Survey for County Partners
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The Department has a new Member Integrity Unit. This unit will investigate suspected client fraud in the Medicaid and CHP+ medical assistance programs.
Please take our survey so we can better understand how we can help you and your teams pursue Medicaid and CHP+ client fraud. You responses will be anonymous unless you provide your contact information in the survey.
For more information, contact Bart Armstrong.
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Health First Colorado Recovery Audits Contractor Begins Work
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The Department has contracted with Health Management Systems, Inc. (HMS) to serve as its Recovery Audit Contractor (RAC) to conduct post-payment reviews of claims submitted for fee-for-service and managed care services. This is a federally-mandated contract program.
In February, HMS began to identify overpayments and assist the Department in recovering any overpayments made to providers for Health First Colorado and CHP+ medical claims.
The RAC audits claims from as far back as 7 years (84 months) from the date the claim was originally paid, and this lookback period applies to all claim and provider types.
All providers are encouraged to update their contact information using the HMS RAC Provider Portal, even if they have not received a letter that they are in an active audit. This is separate from the DXC Technology (DXC) Provider Web Portal. Updating contact information ensures letters get to the preferred address and personnel. Providers who have access to the HMS Provider Portal already for other contracts will need to register for HMS RAC Provider Portal to have access to the RAC audit information. The HMS RAC Provider Portal is a tool that providers can use to track the progress of their audits and add contact information that is specific to RAC correspondence.
If a provider does not update address and contact information in the HMS portal, all correspondence will go to the provider's service address listed in the Colorado interChange. Providers can access the HMS RAC Provider Portal and update contact information.
For more information, visit the HMS Colorado RAC web page.
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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).
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-800-221-3943 (State Relay: 711).
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At a Glance
