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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 June 2019 edition of
At a Glance!
Thank you for your interest!
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| A Message from the Executive Director |
The Department of Health Care Policy
&
Financing is celebrating a successful legislative session along with many Coloradans. This session, bills were passed allowing the import of prescription drugs from Canada, enabling a reinsurance program to lower insurance premiums on the exchange, making hospital financials more transparent including the nonprofits' investments back into the community, and creating a public-option. We are now deep into planning for the next
year.
As we frame initiatives to meet the evolving needs of the Department, the Administration and the state, we are focused on supporting workstreams in the below focus areas.
Affordable Healthcare for all Coloradans
(the Administration's primary healthcare focus)
Lower health care costs to save people money
Control Medicaid Costs
Ensure the right services at the right place and the right price
Improve Medicaid Member Health
Evolve programs that improve member health and outcomes
Improve Customer Service
Increase the quality of service to Medicaid members, providers and partners
Strive for Operational Excellence
Drive compliant, efficient, effective Medicaid business practices that are person and family-centered.
These five focus areas will be part of the FY 2019-20 Department's Performance Plan which will be available
online in July.
Thank you for your leadership and ongoing collaboration,
Kim Bimestefer
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Proposal for Affordable Coverage Option HB 19-1004 Implementation
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The Department and the Colorado Division of Insurance held introductory stakeholder meetings in late May and early June around the implementation of the Proposal for Affordable Health Coverage Option (HB 19-1004).
The bill requires the Department of Health Care Policy & Financing and the Division of Insurance to develop and submit a proposal to the General Assembly by November 15, 2019 concerning the design, costs, benefits, and implementation of a state option for health care coverage.
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Health Care Sharing Programs
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| Buyer Beware: These programs are not health insurance.
The Colorado Division of Insurance (DOI) is alerting Colorado consumers about the risks of health care sharing programs or ministries.
These programs may look and sound like insurance. They may even mimic the look and feel of Affordable Care Act (ACA) health insurance, but they do not offer the benefits of health insurance and do not meet the standards of the ACA.
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Silva Named Office of Community Living Director
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Bonnie Silva has been selected as our Director of the Office of Community Living (OCL). Bonnie brings a wealth of experience, insights, expertise, and passion to this key role within the Department.
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Health First Colorado
The Health First Colorado adult dental benefit is increasing from $1,000 to $1,500 per fiscal year effective July 1, 2019.
Child Health Plan Plus (CHP+)
Effective July 1, 2019, DentaQuest will take over the administration of the CHP+ dental program from Delta Dental. These benefits include:
- Diagnostic services (exams and x-rays)
- Preventive (fluoride, sealants and cleanings)
- Basic restorative services (fillings)
- Endodontic (root canals)
- Emergency dental services
The annual maximum allowable is $1,000 per child per calendar year (January 1- December 31). As with all CHP+ benefits, families with a higher income may be required to pay a small fee (co-pay) when they receive services.
DentaQuest is currently enrolling CHP+ Dental Providers across the state. Contact the recruitment department toll-free at 855-873-1283 or email [email protected] to enroll as a provider.
HB19-1038 has passed. This bill allows dental services for pregnant CHP+ members starting October 1, 2019. This will affect approximately 900 Coloradan women. They will benefit from the same services listed above.
Colorado Dental Health Care Program for Low-Income Seniors
HB19-1326 has
passed.
This bill changes the minimum reimbursement rate for the Dental Health Care Program for Low-Income Seniors to be at least equal to Health First Colorado fee-for-service rates, allows the Dental Advisory Committee to recommend reimbursement rates for all covered services, and requires the Department to consult with stakeholders and report recommendations on how to improve program efficiency.
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Regulatory Efficiency Review
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The Department is required by Executive Order D 2012
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002 (EO2) to conduct a review of its rules to:
- Assess the continuing need for, appropriateness, and cost-effectiveness of its rules; and
- Determine if those rules should be continued in their current form, modified or repealed.
Public comments will be collected through 07/11/2019 for each section of rule below.
All identified rule modifications will go through standard Department rulemaking process.
- 8.100.1 Medical Assistance Eligibility Definitions
- 8.100.2 Legal Basis
- 8.100.3 Medical Assistance General Eligibility Requirements
- 8.100.4 MAGI Medical Assistance Eligibility
- 8.100.5 Aged, Blind, and Disabled, Long Term Care, and Medicare Savings Plan Medical Assistance General Eligibility
- 8.100.6 Aged, Blind, and Disabled Medical Assistance Eligibility
- 8.100.7 Long Term Care Medical Assistance Eligibility
Comments can also be mailed to:
Colorado Department of Health Care Policy & Financing
Attention Health Information Office - Eligibility Policy Unit
1570 Grant St, Denver, CO 80203
Important Note:
Input received must include a citation to the section of rule addressed (example: 8.200). Stakeholders who wish to receive a Department response at the close of the public comment period must also provide their name, the organization they represent (if applicable), and their contact information.
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Hospital Transformation Program Update
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State Plan Amendment vs. 1115 waiver
After multiple conversations with the Centers for Medicare and Medicaid Services (CMS) over the past several months, the Department expects to move to a State Plan Amendment (SPA) for the initial implementation of the developed Hospital Transformation Program (HTP) components.
CMS guidance to the state is to utilize existing federal authority where possible. Most of the program's current recommended framework may be accomplished under the State Plan authority and the Department will seek to utilize waiver authority for more targeted areas of the program that cannot be accomplished under State Plan authority. While the HTP federal authority vehicle is expected to change, no revisions to the program framework or mechanisms are being proposed. Additional information about this potential change can be found on the HTP website.
Quality scoring measures
Quality workgroups continue to meet and refine the quality scoring measures and specifications. The process for finalizing quality scoring measures will include collaboration and input from key stakeholders including the Department, CMS, the Colorado Healthcare Affordability and Sustainability Enterprise Board, the Colorado Hospital Association (CHA), participating hospitals, and broader stakeholders participating in the program. Quality scoring measures for the program will be finalized by August 30, 2019.
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Partnerships to Improve Population Health
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State Innovation Model Connecting Veterans to Resources
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Stacy K. Syphers, the State Innovation Model (SIM) funded veteran health connector (VHC), is connecting military veterans in eastern Colorado with community resources to improve their health and wellness, and she's developing a community-based plan to prevent suicide.
One quick tip that she's giving primary care providers is to ask patients if they're veterans, which can influence health in myriad ways. Asking that one question could help care teams identify the source of a health issue more quickly and ensure better outcomes and the reduction of unnecessary costs.
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Delivery Systems Innovation
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| Transition Services State Tour |
The Department is hosting stakeholder meetings across Colorado to discuss implementation of Transition Services in Home and Community-Based Services (HCBS) waivers and State Plan benefits and the next phase of Colorado Choice Transitions (CCT) program. The purpose of these meetings is to ensure that stakeholders have an opportunity to learn about these changes and ask questions.
CCT is Colorado's demonstration of the federal Money Follows the Person (MFP) grant. CCT enrollment ended December 31, 2018. CCT services for individuals transitioned through CCT will continue until MFP funding for services ends December 31, 2020. However, Colorado has implemented CCT demonstration services into the ongoing Health First Colorado program, now called "Transition Services." Individuals can access Transition Services if they are wishing to transition from an institutional setting to the community or are already living in the community and experiencing a life transition.
Meeting dates and locations:
Colorado Springs - Wednesday, June 26
Pueblo - Thursday, June 27
Durango - Wednesday, July 10
Greeley - Tuesday, July 16
Fort Collins - Thursday, July 18
Lafayette - Tuesday, July 23
Denver - Thursday, July 25
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During the remaining three months of the pilot, the No Wrong Door (NWD) pilot sites will:
- Share their lessons learned during the two year pilot
- Record their exchange of information and resource process
- Discuss the sustainability of their NWD efforts post-pilot
- Inform the design of an inter-agency network that will streamline how individuals access long-term services and supports
For more information visit: www.colorado.gov/hcpf/no-wrong-door-implementation-grant.
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| Substance Use Disorder Benefit Update |
Stakeholder Meetings
Two meetings are planned for the public notice period in August. The dates and locations of those meetings will be announced during July. The Department is also developing a plan for further stakeholder engagement to take place after the public notice period. Those meetings will focus on the implementation of waiver services.
Waiver Application and implementation planning
A first draft of the waiver application is complete. The Department is currently focused on the budget neutrality calculations that are included in the application. The waiver is planned for submission to CMS in October. Departmental staff have identified steps necessary for the billing and coding processes to be in place in advance of the opening of the benefit. Staff are also working with the Office of Behavioral Health to align licensure requirements with ASAM criteria.
For more information, sign up for our Substance Use Disorder Newsletter or contact Kim McConnell.
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| 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.
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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.
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
