This Department of Health Care Policy & Financing (the Department) newsletter is designed to inform county directors, management and staff about high-impact updates, important changes, county performance, new guidance, and program changes. |
|
Letter from the Executive Director |
|
County Partners,
This year, you and your staff have overcome challenge after challenge in order to serve your community and help us connect Coloradans to our health coverage programs. This holiday season, I want to thank you and your staff for your passion and perseverance in helping us serve Coloradans when they need us most - during this economic downturn and global pandemic.
In that spirit, may I ask you to listen to this heartfelt message from me.
Thank you,
Kim
|
|
Colorado Exposure Notifications |
|
You can now download an app to help fight COVID-19, slow its spread, protect yourself and your loved ones. CO Exposure Notifications will quickly notify you if you’ve likely been exposed to the virus, allowing you to seek timely medical attention and take action to protect others. The app is free and does not share your personal information. It can alert you if you have been exposed to COVID-19 in the last 14 days.
Visit AddYourPhone.com to watch a short video about how it works and how to turn it on with Apple or Android devices. |
|
County fact sheets provide an annual snapshot by fiscal year of Health First Colorado (Colorado's Medicaid Program) activity including average annual caseload and top five claim types for each county.
|
|
Recent Memo Series Issued to Counties |
|
OM 20-102
The purpose of this operational memo is to advise eligibility sites of the increased resource limits for Qualified Medicare Beneficiaries (QMB), Specified Low Income Medicare Beneficiaries (SLMB), Qualified Individuals (QI-1), and Low-Income Subsidy (LIS) resource limits.
OM 20-101
This letter is meant to advise counties and eligibility sites of the 2021 Social Security Cost of Living Adjustments (COLA). Please share this memo with all affected Adult and Long-Term Care Medicaid eligibility staff, supervisors, and outside agencies, as appropriate.
|
|
Connect for Health Colorado: Open Enrollment |
|
Community Partners,
Unfortunately, the pandemic is continuing to grow and affect our communities. It is more important than ever to make sure all Coloradans have access to affordable health insurance and thankfully Open Enrollment has begun and is open to Coloradans until Jan. 15. 2021.
Here are some helpful reminders and virtual tools for you:
-
Free, virtual help with enrollment is available from our certified Connect for Health Colorado enrollment experts located throughout the state. If anyone in the community you serve needs help, you can refer them to one of our experts to ensure they get the right health insurance coverage and financial help. Visit the Connect for Health Colorado website to find assistance in your area.
-
Free virtual enrollment events are scheduled throughout the state. To view the calendar, visit their website.
-
The auto renew date changed this year from Dec. 15 to Dec. 1. Current customers should shop and compare in next few weeks so they aren't auto renewed unless they choose to be!
Thank you for being a great partner and helping keep Colorado covered.
|
|
Share how we're providing life-saving care to people across Colorado |
|
Even Coloradans who never thought they'd need public health insurance are being served by Health First Colorado (Colorado's Medicaid program). Following a traumatic brain injury, Mike received life-saving care at no cost thanks to Health First Colorado. Watch Mike’s story and listen to Health First Colorado members tell in their own words how Health First Colorado was there to help. Other Health First Colorado members want Coloradans to know that they may qualify for quality health care coverage. Most Coloradans who apply online learn immediately whether they qualify.
Please help us spread our message by sharing videos where real members tell their stories about getting quality health care through Health First Colorado. It's easy to share! Just visit our member video toolkit to find copy-and-paste messaging and videos to upload to your social media channels.
|
|
Guidance for Residential and Inpatient Substance Use Disorder (SUD) Treatment: Provider Reimbursement for Medicaid effective on Jan. 1, 2021 |
|
On Jan. 1, 2021, Health First Colorado, Colorado’s Medicaid program, will expand its substance use disorder (SUD) benefit. Residential and inpatient treatment and withdrawal management services will be added to the Department’s existing list of covered SUD services, giving members access to a full range of treatment options. The RAEs will be responsible for authorizing inpatient and residential substance use disorder treatments as part of administering Health First Colorado’s capitated behavioral health benefit.
To prepare members, providers and stakeholders for the launch of these new SUD services, the Department will be sending out weekly communications with updated guidance and other information.
The Department has developed the following guidance for inpatient and residential SUD providers to facilitate a smooth transition to Health First Colorado reimbursement for Health First Colorado members already in residential or inpatient treatment when the new benefit begins on Jan. 1, 2021.
SUD residential treatment providers are asked to do the following:
- Enroll as a provider with Health First Colorado.
-
Visit the Provider Enrollment webpage for more information about provider types.
- Discuss with each RAE opportunities for establishing a contracting arrangement.
-
Generate a list of Health First Colorado members in treatment as of Dec. 11, 2020, using the Department's template. The list must contain the following information:
- Member Name.
- Health First Colorado ID.
- Treatment Provider (indicate whether Special Connections provider).
- Date of Admission.
- Anticipated Date of Discharge.
- Contact information for provider staff person.
- Submit the member information from the numbered list above to the Managed Service Organizations by Dec. 14, 2020.
- Coordinate with the individual RAEs as they reach out to discuss treatment plans, support transitions to community-based services for appropriate members, and arrange for stays that will extend beyond Jan. 1 to be reviewed for continued stay authorizations.
-
Beginning Dec. 28, 2020, submit continued stay authorization requests to the RAEs for all Health First Colorado members who will remain in inpatient or residential SUD treatment after Dec. 31, 2020.
- All continued stay authorization requests must be received by the RAEs by Jan. 15, 2021, for members who began inpatient or residential SUD treatment prior to Jan. 1, 2021. Failure to submit continued stay authorization requests by Jan. 15, 2021, will jeopardize a provider’s ability to receive reimbursement back to Jan. 1, 2021, for eligible members.
Providers must be enrolled with Health First Colorado in order to be eligible for reimbursement for services provided to Health First Colorado members.
Additional information will be posted within the next week to better support providers during this transition.
|
|
SSI/SSDI Application Assistance |
|
Five Centers for Independent Living (CILs) across the state of Colorado are currently offering Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) application assistance. Individuals with disabilities needing assistance with the SSI/SSDI application can get help by calling 719-546-1271.
The CILs offering this assistance are:
- Center Towards Self Reliance serving Alamosa, Baca, Bent, Conejos, Costilla, Crowley, Custer, Fremont, Huerfano, Kiowa, Las Animas, Otero, Prowers, Pueblo, Rio Grande and Saguache counties.
- Connections for Independent Living serving Logan, Morgan, Phillips, Sedgwick, Washington, Weld and Yuma counties.
- Colorado Springs Independence Center serving Cheyenne, El Paso, Kit Carson, Lincoln, Park and Teller counties.
- Disabled Resource Services serving Jackson and Larimer counties.
- Northwest Colorado Center for Independence serving Grand, Moffat, Rio Blanco, Routt and Summit counties.
|
|
Hospital Transformation Program (HTP) Update |
|
HTP Implementation Update
As a state and nation, we are witnessing the COVID-19 pandemic continue to worsen and hit unprecedented levels while having major impacts on our communities and hospitals. On Nov. 20, Executive Director Kim Bimestefer authorized the decision to move the start date for the HTP from Feb. 1, 2021 to April 1, 2021. This is part of the Department’s continued effort to support our hospitals during this crisis and our commitment to set the HTP up for success. Additional details and updated program timelines will be shared through the HTP listserv. To be added to this listserv, please contact Courtney Ronner.
Rural Support Payment Update
The Rural Support Payment is an integral part of the HTP that will aid in making the concepts of HTP operations a reality for many rural hospitals. Total funding available is $12,000,000 per year for five years, beginning with federal fiscal year (FFY) 2020-21. On Dec. 3, additional information was shared with program participants and stakeholders, including a list of qualified hospitals.
Link to HTP Refresher Training
A HTP Refresher training took place on Tuesday, Nov. 10. The training was recorded and can be found on the HTP website under “Tools & Resources.”
HTP Community Advisory Council
Community Advisory Council meetings continue to take place on a monthly basis, with the most recent meeting taking place on Monday, Nov. 16. The agenda, meeting materials and previous meeting notes can be found on the HTP Community Advisory Council website.
Colorado Healthcare Affordability and Sustainability Enterprise (CHASE) Board meeting
A CHASE Board meeting took place via webinar on Tuesday, Dec. 15 at 3 p.m. Additional information about the board, as well as meeting materials can be found on the CHASE Board website.
|
|
Upcoming Change to Reasonable Opportunity Period (ROP) |
|
The Department is changing the timeframe in which we will verify a Health First Colorado or Child Health Plan Plus (CHP+) applicant's income.
Beginning in Spring 2021, the Department will be narrowing the window for a member to provide verification for an income discrepancy from 90 to 30 calendar days, when requested. This change is based on member feedback that this timeframe reduces confusion because it better aligns with other timelines in the eligibility process.
In addition, the Department is excited to upgrade to a more timely income verification process that pulls from multiple database sources. We hope doing so will help us verify income automatically without needing to request additional proof of income from applicants.
|
|
County Grants & County Incentives Program |
|
FY 2020-21 County Incentive Program
The Semi-Annual Status Report for Reporting Period 1: July 1 through Dec. 31, 2020, will be sent out the third week of January. The status report will provide a high-level update on each county’s performance for the past six (6) months. The report will include Timeliness, LTSS Timeliness, Backlog, and Timeliness of Case Maintenance and Disenrollment. The Cyber Security and Training & Quality Incentives are measured at the end of the fiscal year (the end of the second reporting period).
As a reminder, each incentive's Operational Memo should be a main reference for where and how to pull reports.
At the end of Reporting Period 1, counties will be notified whether they qualify for an exemption request. Counties that are qualified to request exemption will have 10 business days to submit all the required documentation. The Department will review the document and will notify the county if the exemption is approved, partially approved, or denied.
Training and Quality Incentive
The most updated training progress report will be sent out at the same time. We will ask each county to review the SDC trainings completed and CBMS user report to ensure all the information is accurate. If there is a discrepancy, we ask counties to contact the County Team with the correct information.
Quarter 2 Quality Check-In meeting information (date/time) will be sent out 3rd week of December. The next quality meetings will be held sometime in February.
|
|
The County Grant Program is a great opportunity for counties to use to implement new programs or improve existing programs that will impact the county’s performance. Currently, counties that are awarded the grant have been implementing programs to improve quality assurance, improve error rates, increase Medicaid providers, and connect uninsured individuals to resources and to apply for Medicaid.
Application for the next fiscal year will be released in May 2021.
|
|
Timeliness for November 2020 |
|
Timeliness for all Medical Assistance applications was measured at 98.81 percent. |
|
Timeliness for all Medical Assistance redeterminations was measured at 98.54 percent. |
|
Department Contacts & Resources |
|
|
|
|
|
|
