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 Executive Steering Committee (ESC) has approved
August 25, 2019
, as the launch date for CBMS Transformation Phase 2. Thank you for your patience as we reached this decision. We will be back in touch soon to continue to share additional resources that will help you prepare for Go-Live.
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Letter from the Executive Director
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County Partners,
Over the past five years, the Department has implemented multiple initiatives to combat overprescribing and excess opioid utilization within Health First Colorado. These initiatives, along with provider education and heightened public awareness of the opioid crises, have resulted in a
more than 50 percent reduction
in the number of opioid units dispensed to Health First Colorado members and a
44 percent reduction
in the number of members using opioids from January 2014 – December 2018.
Some of our Department initiatives over the past five years include:
- Tightened criteria on short-acting opioids and added quantity limits
- A pain resource webpage with information on opioid use/misuse, pain assessment guides, risk assessment tools and methods to reduce opioid use safely and effectively
- A Chronic Pain Disease Management Program to help train providers in appropriate use of opioids
- Limiting initial prescription fills to a 7-day supply and limiting the member to two refills
- Reducing the daily maximum dose from 300 MME/day to 200 MME/day.
- Implementing a dental opioid policy limiting members to three, four-day prescription fills
Click here
to review our press release, which includes a year by year evolution of our opioid policy intended to combat addiction and opioid overprescribing. In 2020 the Department will launch a tool for all providers to help them reduce the chances of addiction among their patient populations. The tool is being designed in collaboration with physician groups, insurance carriers and stakeholders.
Together, we are tackling excess opioid utilization, which is protecting our members from the devastating consequences of addiction while ensuring access to proper pain management therapy. Thank you for your partnership as we work to make Colorado the healthiest state in the nation.
Thank you for your leadership and ongoing collaboration,
Kim
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Updates on Proposal for Affordable Coverage Option HB 19-1004 Implementation
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The Department of Health Care Policy & Financing 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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Register for the CGHSFOA Accounting Conference
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Tuesday, September 10th To Thursday, September 12th, 2019
Festivities Commence At 9:00 AM On Tuesday
Please join us for 2019 in the town of Steamboat Springs, Colorado for the Annual Accounting Conference hosted by CGHSFOA. This will be an opportunity to develop closer relationships with colleagues throughout the state while increasing your understanding of accounting and financial issues relative to Human Services in Colorado.
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Recent Memo Series Issued to Counties
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PM 19-003
The purpose of this Memo is to clarify that the Department of Health Care Policy and Financing (“Department”) is the sole administrator of Health First Colorado/Medicaid (“HFC”), though it does delegate duties, as outlined in state statute, which are supervised by the Department, to county departments of human/social services. This Memo will be available to all county leadership and staff to enable them to unambiguously identify the Department as the single state administrator of HFC, a designation required by federal law. This will help counties to understand the meaning of references to “the administrator,” or similar variations thereof, which appear in federal and state statutes and rules relating to HFC, and to appreciate the general allocation of HFC responsibilities between the Department and the counties.
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OM 19-028
The purpose of this operational memo is to advise the eligibility sites of the increase to the Community Spouse Minimum Monthly Maintenance Needs Allowance (MMMNA) and Shelter Allowance. Please share this letter with all eligibility staff, supervisors and administrators that manage nursing facilities, Home and Community Based Services (HCBS), the Program of All Inclusive Care for the Elderly (PACE), and other outside agencies, as appropriate.
OM 19-030
The purpose of this Operational Memo is to provide guidance to county departments of human/social services (county) on the FY 2019-20 County Incentives Program Training Incentive.
OM 19-032
The purpose of this memo is to advise eligibility sites on how to receive and enter temporary census income related to the 2020 Census Demonstration Project for medical assistance cases. All eligibility sites are requested to follow the procedures outlined below regarding temporary census income for MAGI and Non-MAGI Medical Assistance cases. Please share this memo with staff members as deemed necessary.
OM 19-034
The purpose of this Operational Memo is to provide guidance to county departments of human/social services (county) on the FY 2019-20 County Incentives Program Eligibility Performance Incentive.
OM 19-035
The purpose of this Operational Memo is to inform county departments of human/social services (county) of operational instructions to implement the Food Security Incentive as part of the FY 2019-20 County Incentives Program.
OM 19-036
The purpose of this Operational Memo is to provide guidance to county departments of human/social services (county) on the FY 2019-20 County Incentives Program Cybersecurity Incentive.
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HCPF Informational Updates
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Hospital Transformation Program Update
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The Department will host an HTP Stakeholder Engagement Forum to give all those involved in the program an opportunity to provide feedback to the CHASE Board as well as Department staff. Details about the forum will be forthcoming in the HTP Newsletter. If you're interested in participating in the HTP Stakeholder Engagement Forum,
please fill out the following form
.
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 of Health Care Policy & Financing (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.
Update on HTP timeline
HTP Newsletter
Those interested in email updates about the HTP should
sign-up through the HCPF website
for the HTP Newsletter. To complete the sign-up process, enter your contact information and click the “Hospital Transformation Program” box.
If you’re like to know more about the HTP, we encourage you to visit
the HTP website
as well as read past editions of the HTP Newsletter in
our online archives
. If you have additional questions about the HTP, please contact Courtney A. Ronner, Hospital Relations and Communication Manager,
via email
or by phone at 303-866-2699.
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Medical Assistance (MA) Site Update
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Over the past two years we have been working with the Centers for Medicare and Medicaid Services (CMS) to gain approval on enhanced funding for Medical Assistance (MA) sites. During this process, questions regarding MA roles and responsibilities have been discussed.
According to 42 C.F.R. § 431.10, the Department can delegate authority for eligibility determinations to Governmental entities with merit-based employees. Most MA sites do not meet this regulation. The good news is that we can comply with federal regulations and continue a partnership with MA sites with a few modifications:
- We will reclassify MA sites as out-stationing sites.
- We will rename the sites; the new name is still to be finalized.
- Roles, responsibilities, and contracts will be modified to meet federal requirements. This includes limiting MA sites to only accepting and processing intake applications within CBMS.
We are exploring the use of PEAKPro (PEAK Professional) to help support MA sites with ongoing case maintenance (Add a Baby, address changes, verification requests, Report My Changes, and RRRs). PEAKPro is designed to allow sites to process ongoing maintenance eligibility requests.
We are optimistic that PEAKPro may support MA sites with some of the ongoing maintenance needed to serve our members. However, the member modules within PEAKPro have not been utilized and operationalized with any sites. Based on this, we will be performing a pilot phase to fully understand how this may be integrated for MA sites to use.
These changes are tentatively scheduled to take place fall/winter of 2019. This will allow us time to complete the pilot, provide training, provide clarity on roles and responsibilities, and execute new contracts. We are committed to communicate promptly once we have additional information to share. For additional questions, please contact Rebeca Ornelas.
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Polis Administration Projects 18.2% Average
Decrease
in Premiums for Individual Health Insurance Plans in 2020
Today, the Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), announced that for the first time ever, Colorado health insurance companies that sell individual plans (for people who do not get their health insurance from an employer or government program) expect to reduce premiums by an average of 18.2 percent (-18.2%) over their 2019 premiums, provided the reinsurance program is approved by the federal government. These are the health insurance plans available on the Connect for Health Insurance Exchange, the state’s health exchange made possible by the Affordable Care Act (ACA).
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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.
This does not take the place of public testimony at the Medical Services Board meeting and anyone who wishes is invited to come to the MSB meeting to address the Board directly.
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County Grant & County Incentives Programs
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FY 2018-19 Incentives Closeout
- The dispute period for Reporting Period 2 Status Reports has ended
- Final Status Reports will be sent out early to mid-August
FY 2019-20 Incentives Resources
Operational Memos for new incentives have been released. Find them all on the County Administration webpage.
Updated Documents:
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Grant Applications Noticing
Noticing of grant approval/denial will occur the first week of August.
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Timeliness for all Medical Assistance
applications
was measured at
97.73 percent
.
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Timeliness for all Medical Assistance
redeterminations
was measured at
98.88 percent
.
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Census Outreach Grant Application Available
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The Department of Local Affairs' (DOLA) announced last week that the Census Outreach Grant program application will be available August 15. Want more info? Find it
HERE
To get a better idea about public health’s participation in this work and how we might help LPHA’s to receive these funds, CALPHO and Trailhead are asking you complete this quick 3 question
survey
.
The grants will provide funds to local governments, intergovernmental agencies, councils of government, housing authorities, school districts, nonprofit organizations and the Southern Ute and Ute Mountain Ute tribes to support the accurate counting of the population of the state for the 2020 census. Activities covered by the grant include 2020 census outreach, promotion, and education to focus on hard-to-count communities in the state.
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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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