County Connections Newsletter
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This newsletter is designed for the Department to inform county directors, management and staff about county performance, policy changes, process updates, upcoming due dates, and more.
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High-Impact Policy and Process Updates
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CBMS Transformation Update
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The CBMS Transformation Team is completing the Phase 0 shift from the on-premises server to Amazon Web Services (a secure cloud services platform). During the transition, there will be a CBMS System outage for three days. The CBMS System is
projected
to be down
starting at 6:00 p.m. on Thursday, September 6
th
and will be available by the start of the business day on Monday, September 10
th
(7:00 am).
The CBMS Transformation Project is well underway, and the Team is working towards the projected implementation from the on-premises server to Amazon Web Services (AWS) in September.
The CBMS Transformation Team wanted to inform you of this projected implementation, so you can work with your leadership to start planning for the system outage. At this time, we are informing you of CBMS downtime and more detailed information will be forthcoming about this outage time frame. We appreciate your understanding as we work to make these changes as part of the CBMS Transformation Project.
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Implementation Updates: Known System, Policy & Other Issues
The Department has developed a section of its
Provider & Stakeholder Resource Center
dedicated to
Implementation Updates
on known system, policy and other issues related to the launch of ACC Phase II. The content on the page is not intended to be an all-inclusive list of ACC Phase II topics but will reflect known system, policy and other issues that have been identified; as well as solutions or workarounds that have been developed where applicable. We encourage providers, stakeholder and other interested parties to check back often for updates.
Data Analytics Portal Resources
To support the ACC's goal of improving member health and reducing costs, the Department has contracted with IBM Watson Health (formerly Truven) to host the
Data Analytics Portal (DAP)
, which replaces the former Statewide Data and Analytics Contractor (SDAC). This data analytics tool for PCMPs and RAEs includes population and performance information. See the
Data Analytics Portal resource page
for more information and user guides.
Behavioral Health Services Resource
Beginning July 1, the RAEs began serving as the single entity responsible for coordinating both physical and behavioral health (defined as mental health and substance use disorder) for Health First Colorado (Colorado's Medicaid Program) members and administering the capitated behavioral health benefit. These are the duties previously contracted by Regional Care Collaborative Organizations (RCCOs) and Behavioral Health Organizations (BHOs).
Key Performance Indicator Methodology and Behavioral health Incentive Program Specifications
Common Member Questions
What is a Health First Colorado regional organization?
Your regional organization manages both your physical and behavioral health care. They support a network of providers to make sure you can access health care for your body, vision, mental health, and substance use in a coordinated way. Every Health First Colorado member belongs to a regional organization. Your regional organization is on your enrollment letter. For more information to go
HealthFirstColorado.com/health-first-colorado-regional-organizations
.
My specialist is the doctor I see the most and the one I use as a primary doctor, will I not be allowed to do this anymore?
You can keep seeing the specialist the way you have been. If you have any trouble with this, contact your
regional organization
.
Key Resources
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CHRP Waiver Benefits Collaborative
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The Department of Health Care Policy & Financing has scheduled a Benefits Collaborative meeting for
August 24th, 2018
to discuss redesign of the Children’s Habilitation Residential Program (CHRP) waiver.
The Benefits Collaborative process is the Department’s formal, public, policy development process. The process is used to define coverage policy – what is covered and who can provide/receive covered services – in a manner that is transparent to, and inclusive of, all stakeholders, using evidence-based guidelines. To learn more about CHRP waiver redesign, visit the Department’s
website
.
The Benefits Collaborative process is open to anyone who indicates they wish to participate. You are encouraged to forward this invitation to anyone that may be interested.
Please indicate your interest in receiving future CHRP Waiver Benefits Collaborative emails and please RSVP if you plan to attend the August meeting by emailing
Kimberley.Smith@state.co.us
.
This will help us ensure adequate meeting space. A webinar participation option will be provided to those who indicate they wish to attend remotely.
CHRP Waiver Benefits Collaborative Meeting
Friday, August 24, 2018
2:30 pm – 5:00 pm
Department of Health Care Policy and Financing
303 E. 17
th
Ave, Denver, Seventh Floor Conference Rooms 7ABC
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HCPF Department Updates - Informational
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Letter from Executive Director Kim Bimestefer
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Dear County Leader:
I had the opportunity to meet many of you at our County Grants Program Report Out last month and hear about your innovative ideas in person. Thank you for the work you do to serve our members. I look forward to meeting more of you over the coming months.
I wanted to share information about a bill that was recently signed by Governor John Hickenlooper. “Controlling Medicaid Costs”,
Senate Bill 18-266
, passed the House and Senate with unanimous support and better enables the Department of Health Care Policy & Financing (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
This bill will help 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.
We will be sharing updates about this and other initiatives with you over the coming months in this newsletter.
Thank you again for your work to serve our members,
Kim
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Memos and Department Communications
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Policy Memos
–
Operational Memos –
Informational Memos –
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Public Rule Review Meeting
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Public Rule Review meetings
are an opportunity for stakeholders to have one on one conversation with the Department's rule author regarding draft rules.
Public Rule Review meetings happen on the second Monday after the second Friday of each month. Stakeholders can attend in person or can e-mail feedback to the rule author before the rule goes to the Medical Services Board.
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Income Eligibility Verification System (IEVS) Frequently Asked Questions
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In June 2018, the Colorado Benefits Management System (CBMS) implemented updates and enhancements to the Income Eligibility Verification System (IEVS) and its use of Reasonable Compatibility for Medical Assistance categories. This included implementing a reasonable compatibility check for Non-MAGI categories. This effort aligns system functionality with policy ensuring that Colorado Department of Labor and Employment (CDLE) income records are considered appropriately for both MAGI and Non-MAGI categories.
This project did not change the policy or rules for when an IEVS letter is sent. Members receive an IEVS letter when their self-reported income and the amount their employer reports to CDLE are significantly different or, more precisely, not reasonably compatible. The member is asked to provide an explanation of why the numbers are different, and/or to provide proof that the income received through IEVS is inaccurate.
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Household Composition for MAGI Programs FAQs and Monthly Budget Unit (MBU) Flowchart
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For Modified Adjusted Gross Adjusted Income(MAGI) Medical Assistance programs, household composition is determined for everyone in the household based on federal tax rules. In most cases, this consists of tax filers and their tax dependents. However, there will be exceptions for some households. MAGI households are determined in three different ways: Tax Filer Rules, Tax Dependent Rules and Non-Tax Filer rules.
The Department has posted a Frequently Asked Questions (FAQs) sheet for household composition for Modified Adjusted Gross Income (MAGI) Medical Assistance Programs. These FAQs provide further guidance on determining MAGI household composition and Monthly Budget Units (MBU) and are based on Tax Filer Rules, Non-Tax Filer Rules, and Tax Dependent Rules. Please click
here
to view the MBU FAQs.
The Department has also posted the Household Composition MBU Flowchart to assist eligibility workers in determining household composition for MAGI Medical Assistance programs. Please click
here
to view the MBU Household Composition Flowchart.
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New Verification Checklist Webinar
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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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IDD Waiver Renewal Stakeholder Workgroups
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WHEN: First meetings are on
August 23, 2018
The Department is hosting series of stakeholder meetings in August and September for the upcoming 2019 renewal of the Children's Extensive Supports (CES), Developmental Disabilities (DD), and Supported Living Services (SLS) waivers. These meetings will discuss the technical aspects of the waiver applications and language that is currently contained within related documents. Please visit
https://www.colorado.gov/hcpf/idd-renewal-stakeholder-workgroup
for more information.
Stakeholders interested in participating in these meetings should email
HCBSwaivers@state.co.us
to be added to the distribution list for these communications. Please indicate whether you are interested in receiving information for DD and SLS waivers, the CES waiver, or both.
The Department sent out an Informational Memo (
IM 18-015
) on July 23, 2018 announcing the upcoming meetings.
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County Grant & County Incentives Programs
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The Department has released guidance regarding implementation of the FY 2018-19 County Incentives Program:
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Quarter 1 Grant check in calls have been scheduled - contact the County Team if you do not know when your county's check in call will take place.
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Timeliness for all Medical Assistance
applications
was measured at
97.29 percent
. The Department and its county partners have registered 48 consecutive months above 95 percent timeliness.
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Timeliness for all Medical Assistance
redeterminations
was measured at
99.15 percent
. The Department and its county partners have registered 28 consecutive months above 95 percent timeliness.
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Connect for Health Colorado
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New Eligibility System (NES)
Connect for Health Colorado (C4HCO) is reaching out to let you know that we are developing a New Eligibility System (NES) for this coming open enrollment period. We are working closely with the Department of Health Care Policy and Financing (HCPF) and the Governor’s Office of Information Technology (OIT) on
functionality changes and engaging various stakeholder groups, including county representatives, on communications and change management.
In an effort to keep you informed, we have created a one-page
Fact Sheet
for your reference (attached). We encourage you to print this out and keep it handy in case questions from clients or customers arise. Some highlights include:
What NES is:
- C4HCO is developing a separate eligibility system for Advanced Premium Tax Credits and Cost Sharing Reductions.
- The system will be funded, developed, and maintained entirely by Connect for Health Colorado.
- It will be implemented by November 1, 2018 (for Plan Year 2019).
- Only minor changes to PEAK language and CBMS client correspondence will be made.
What NES is not:
- Changing eligibility rules and guidelines.
- Being funded by Federal or State dollars.
- Requiring county workers to do additional work when processing in CBMS.
Why we are doing it:
- Streamline the customer experience.
- Continue to meet federal compliance obligations.
- Control system enhancements and troubleshooting with more speed and flexibility.
If you have any questions, please contact Jessica Smith at
jsmith@c4hco.com
or visit the
NES webpage
dedicated to the most current information.
New Eligibility System Training
C4HCO will host four 30-minute training webinars including a Q&A session at the end. Dates/Times of the webinars are as follows:
Wednesday, September 26, 2018:
- 9:00-9:30 a.m.
- 3:30-4:00 p.m.
Wednesday, October 3, 2018:
- 9:00-9:30 a.m.
- 3:30-4:00 p.m.
Webinars will be recorded and posted on CO.Learn for those who cannot attend.
These training hours will count towards the HCPF County Incentives.
Specific links/call-in information for these webinars will be sent out via CBMS communication and CHSDA Roundup emails in September. Please reach out to Jessica Smith at
jsmith@c4hco.com
with any questions.
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Department Contacts & Resources
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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).
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
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Colorado Dept. of Health Care Policy & Financing
(303) 866-2993 | 1570 Grant Street, Denver, CO 80203
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