The new year has already been full of informative events and exciting new developments!

We presented our $12.3 billion 2021-2022 fiscal year proposed budget at the Joint Budget Committee hearing last month, presented to the Senate Health & Human Services and House Public & Behavioral Health & Human Services committees as part of the SMART Act requirements, and released our 2019-20 Annual Report. The annual report illustrates the many ways we serve Coloradans each and every day, including videos in our members’ own words. We invite you to review it and celebrate all that we accomplished together this past year.

Vaccines are now rolling out to those over 65 years of age. We appreciate your help reaching the one in four Coloradans who are Health First Colorado members to ensure they are able to get their vaccine when it’s their turn. Of course, members will not be charged a co-pay for the vaccine or for their ride to and from their appointments. We also recently communicated to providers the amount that Medicaid will pay for the administration of the first and second doses. As the vaccine rolls out, please continue to follow public health protocols by washing your hands, wearing your masks and maintaining 6-feet of physical distance from those outside your households, and please help us lead others in doing the same.

Since the start of the pandemic, the number of Coloradans we serve has grown by more than 175,000 people. This growth is now projected to continue rather consistently all year, with the “likely extension of the Public Health Emergency” (PHE) through the end of 2021, as recently communicated by the U.S. Department of Health and Human Services. In this same spirit, and in alignment with the federal government opening the federal exchanges, Connect for Health Colorado, our state exchange, is also holding a special enrollment period from Feb. 8 - May 15. Together, our efforts are connecting Coloradans to affordable coverage, especially those who have lost their jobs during this economic downturn. Thank you for your partnership on this important work. We are here for Colorado.

On the affordability front, we hosted the Health Cabinet Health Policy Summit virtual conference, which included five remarkable sessions and over 1,850 registrants. Agency leads, state and national experts discussed initiatives to reform our behavioral health system, get Coloradans vaccinated, help employers control their health care costs, support rural hospitals, improve the effectiveness of hospital community investments, and reduce prescription drug costs. This latter topic included a review and discussion of the top recommendations within the Department’s newly released and updated prescription drug report. In support of one of the recommendations in that report, the Department released an invitation to negotiate on drug importation, inviting domestic and foreign partners to help us import drugs from Canada, which will drive savings of over 60% on importable drugs. As part of the Summit, we also launched a new affordability webpage with tools to help communities address the many factors that contribute to rising health care costs.

In partnership with the Colorado Hospital Association, the Colorado Healthcare Affordability and Sustainability Enterprise (CHASE) legislative report demonstrates some of the ways we are innovatively addressing costs by collecting a hospital provider fee. We invite you to review this report to learn how we disbursed $393 million in increased reimbursement to hospital providers, reduced uncompensated care costs and the need to shift those costs to other payers, while expanding coverage to an additional 502,000 Coloradans and providing $114 million in relief to the state’s General Fund.

We look forward to collaborating with you on many other initiatives this year to help us serve our growing membership while saving Coloradans money on health care. As always, we are deeply grateful for your partnership!

Kim Bimestefer

All counties received their requested number of tokens for all four systems (CBMS, ACSES, CHATS and Trails) in August last year. Medical Assistance and Presumptive Eligibility sites have been mailed their needed tokens as well. ACSES and CHATS previously deployed 2FA with PingID. Trails go-live is on hold. Please note if a user has a token for one of the other systems, the same token can be used for CBMS. Included for your reference is the 2FA User Guide and FAQ, which will continue to be updated as needed.

During the COVID-19 public health emergency, counties, Medical Assistance (MA) sites, Presumptive Eligibility (PE) sites and Certified Application Assistance sites (CAAS) will be authorized to assist individuals applying for Medical Assistance remotely (telephone, video conferencing, etc.) upon receipt of verbal consent. The authorization of verbal consent will expire at the end of the Public Health Emergency. Normal policies and procedures will resume when the federal emergency period ends. The Department has released a memo "Remote Application Assistance" for more guidance.

For more information, read the related Policy Memo.

All Memos and their attachments can be found on the Memo Series website.

PM 21-002

The purpose of this Policy Memo is to communicate to county member fraud investigators the requirement for Continuous Enrollment during the Coronavirus (COVID-19) public health emergency (PHE), and the related implications on member fraud investigations, eligibility terminations, and overpayments. This memo will be available to all county staff working on member fraud investigations.

PM 21-001

The purpose of this Policy Memo is to inform authorized individuals/entities such as

Counties, Medical Assistance (MA) Sites, Eligibility Application Partner Sites,

Presumptive Eligibility (PE) Sites, and Certified Application Assistance Sites (CAAS) that

they may assist applicants in completing the Application for Medical Assistance remotely

(telephone, video conferencing, etc.) during the COVID-19 Public Health Emergency

period. This guidance will exclude the disability application. Assisters should follow the

existing process for the disability portion. Assisters listed above have the option to

assist applicants to complete the application remotely. This interim process will not be

mandatory. Please share this memo with all eligibility staff, supervisors, and outside

agencies, as appropriate.

OM 21-023

The purpose of this operational memo is to advise county departments of human/social services and Medical Assistance sites of income changes to the Health First Colorado Buy-In Program for Working Adults with Disabilities (WAwD). Please share this information with anyone who works with this program.

OM 21-022

The purpose of this memo is to advise eligibility sites of the Medicare Savings Program (MSP) and Low-Income Subsidy (LIS) income limits. MSP Categories include: Qualified Medicare Beneficiaries (QMB), Specified Low-income Medicare Beneficiaries (SLMB), Qualified Individuals (QI-1) and Qualified Disabled Working Individuals (QDWI). Please share this memo letter with anyone who works with these programs.

OM 21-021

The purpose for this memo is to notify eligibility site staff of the income guidelines for the Modified Adjusted Gross Income (MAGI) Medicaid program and the Child Health Plan Plus (CHP+) program effective Apr. 1, 2021.

OM 21-019

The purpose of this Operational Memo is to inform eligibility sites of changes being made to the Reasonable Opportunity Period (ROP) policy and Colorado Benefit Management System (CBMS). Changes made to the policy and to CBMS will reduce the ROP for income discrepancies from 90 calendar days to 30 calendar days for Modified Adjusted Gross Income (MAGI) and Non-MAGI programs.

OM 21-018

The purpose of this Operational Memo is to inform eligibility sites of operational instructions to meet Federal requirements to include Net Operating Loss (NOL) as an allowable deduction for MAGI-based programs.

OM 21-015

The purpose of this Operational Memo is to advise eligibility sites that the Internal Revenue Services (IRS) has suspended the requirement to mail physical copies of the 1095-B form to Health First Colorado and Child Health Plan Plus (CHP+) members. The memo provides instructions on how to furnish a copy of the 1095-B form to Health First Colorado and Child Health Plan Plus (CHP+) members if requested. This guidance is for the 2020 tax year and later, or until states receive further guidance from the Internal Revenue Services (IRS).

OM 21-011

This Memo is intended to provide operational guidance for County Departments of Human/Social Services and Eligibility Sites regarding the Medicaid Estate Recovery Program and the noticing requirements to Health First Colorado (Colorado’s Medicaid Program) members.

OM 21-005

This Operational Memo communicates to county departments of human/social services and other eligibility sites the program requirements and processes for the Department of Health Care Policy and Financing (referenced herein as “the Department” or “HCPF”), in its statutory oversight role in the administration of the Medical Assistance Program, to implement site audits through the HCPF Management Evaluation (ME) Review Program. These site reviews will occur over a multi-year cycle and aim to address county or site compliance issues discovered by the ME Review Program and routine monitoring, quality assurance, administrative desk reviews and other types of Department supervision activities.

The purpose of this Operational Memo is to document the program requirements and processes used for the HCPF ME Review Program site reviews. Non-compliance with ME Review Program requirements and processes, as determined by the Department in its statutory oversight role, can result in notification of non-compliance as found in HCPF Operational Memo 21-004, “Improvement Action and Corrective Action Plans.”

OM 21-004

The Department of Health Care Policy and Financing, referenced herein as “the

Department” or “HCPF”, has the statutory responsibility for oversight of the Colorado

Medical Assistance Program (Medicaid) as defined by Colorado Revised Statutes

[Section 25.5-1-114(3)]. Medicaid is known as Health First Colorado. Medical

Assistance also includes the Children’s Basic Health Plan known as Child Health Plan

Plus (CHP+). The purpose of this Operational Memo is to document the processes used

to monitor the county department of human/social services, referenced herein as “the

county” or “counties” and subsequent improvement actions or corrective actions

required to correct any determined deficiencies.

The process as documented in this Operational Memo shall be used by the Department

until further notice.

IM 21-004

The purpose of this Informational Memo informs providers that the Colorado Department of Public Health & Environment's (CDPHE) has created a three-phase plan to be as fair as possible about when people get the COVID-19 vaccine. The plan is based on people's risk of serious complications and death from the virus.

Colorado Department of Public Health and Environment (CDPHE) announced that as of Feb. 19 the vaccine data dashboard includes county-level vaccine administration data in beta. 

Continue to stay up to date by visiting the Colorado COVID-19 website.

President Joe Biden issued an Executive Order re-opening enrollment of the Affordable Care Act marketplaces. While the order pertains to states that use the federal exchange (healthcare.gov), Colorado’s exchange (Connect for Health Colorado) will mirror the order by also re-opening enrollment. In fact, Coloradans without health insurance will be able to enroll in coverage through ConnectforHealthCO.com between Feb. 8 - May 15, 2021. This special enrollment period is for people who are without health insurance and begins a week earlier than the federal exchange.

Re-opening the exchanges is an effort to help uninsured Coloradans connect to affordable coverage - especially those who have lost their jobs during this economic downturn. Given the work we have done with stakeholders to accomplish this shared goal, we want to maximize this special open enrollment opportunity to connect Coloradans who are eligible to our safety net programs, as well.

In that spirit, concurrent to this special enrollment period, we would appreciate your communication out to your network of contacts about this special open enrollment period, as well as our Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+) coverage programs. Due to COVID-19, our county partners have asked that communications refer applicants to our PEAK online tools. As you know, we have created a variety of materials you can use for outreach on our Here for You, Colorado website, including this helpful enrollment tool (also available in Spanish). Income eligibility information can be found here, as well.

Thank you for your ongoing collaboration and partnership in serving our members and keeping Coloradans covered during this pandemic.

As a result of legal changes, Health First Colorado and Child Health Plan Plus (CHP+) members no longer need to provide proof of health insurance coverage in order to file their taxes. Therefore, the Department will not be mailing out 1095-B forms this year. Although the 1095-B is no longer required for tax filing, members can get a copy of their 1095-B for their records. Please visit the resources below for options on obtaining a 1095-B form.

For more information, read the related Operational Memo and our FAQ.

For more information about Friday Health Plans, members can visit www.fridayhealthplans.com, or contact Friday Health Plans Customer Service by calling 1-719-589-3696 or 1-800-475-8466. 

For more information about the CHP+ program, members can visit www.cchp.org, or contact CHP+ Customer Service by calling 1-800-359-1991.

The Health Care and Economic Security Staff Development Center (SDC) has released several training materials that are part of the February 2021 CBMS Build. The projects for the February Build will be implemented into CBMS on Feb. 13, 2021.

This CBMS Build Cover Sheet provides a high-level summary of this month's build training projects and contains a direct link to release notes for all the projects.  For all builds, this document will be placed on TrainColorado.com in the Document Library. 

To access the WBTs, users will need to log into CoLearn and search for the projects listed on the cover sheet. 

If you have any further questions about this guidance, please email the Staff Development Center.

information is available at the Health First Colorado Mobile App website.

One in four Coloradans are covered by Health First Colorado (Colorado’s Medicaid program). Coloradans from across the state and all walks of life get their healthcare from Health First Colorado, including people who never thought they’d need public health insurance. Arlene and Pedro were able to get health care coverage for their girls from Health First Colorado. They want you to know that everyone needs help sometimes, and applying for Health First Colorado is easy. Watch the Soto Ynigo family’s story in English or in Spanish and listen to Health First Colorado members tell in their own words how Health First Colorado was there to help.  

For additional information please refer to the County Admin webpage.

As a reminder, each incentive's Operational Memo should be a main reference for where and how to pull reports.

The required Q2 Quality Check-in is Completed. Counties are required to submit Counter Measure Action Plan by the due date (four weeks from the day counties attended the Q2 Quality Check-in meeting – power point with the due date and contact information sent out). This Action Plan will count for the Q3 Quality Check-in meeting. The Department will follow up for the Q4 Quality Check-in Meeting date.

The Department understands there have been questions on timely case maintenance when we are not disenrolling members due to PHE. The Department is looking into that and will not hold counties to a measure outside of their control.

The original intent of this incentive was to redetermine locked-in members’ eligibility at the end of the PHE within the 90-day timeframe provided by the federal government. Although the federal government has new guidance and extended the PHE, counties can use this incentive to greatly lessen the eventual workload at the end of the PHE. This will meet the original intent of the incentive and reduce future burden on counties across the state. The Department will send out updated guidance on working certain aid codes on the COVID locked-in report through an Operational Memo shortly.

For counties participating in the grant program, Q3 Grant Check-in is scheduled for the second week of March.

Questions? Reach out to Rahem Mulatu.

Timeliness for all Medical Assistance applications was measured at 98.46 percent.

Timeliness for all Medical Assistance redeterminations was measured at 95.17 percent.