County Connections Newsletter
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This Department of Health Care Policy & Financing newsletter is designed to inform county directors, management and staff about county performance, policy changes, process updates, upcoming due dates, and more
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Message from the Executive Director
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County Partners,
This month, I would like to address what the Department of Health Care Policy & Financing (the Department) is doing to support our providers, partners and fellow Coloradans during this unprecedented public health crisis.
We serve more than 1.2 million Coloradans through Health First Colorado (Colorado's Medicaid program), Child Health Plan Plus (CHP+) and other health care programs. With the advent of the novel coronavirus (COVID-19) pandemic, our Department is being called upon to serve more Coloradans than ever before.
Although we have seen dramatic increases in our member numbers before -- especially when we expanded Health First Colorado under the Affordable Care Act -- we have never experienced a projected membership increase of this magnitude in such a short span of time. To adapt, we are implementing numerous system and policy changes under challenging time constraints and we appreciate your partnership through this time of dynamic change:
- As a first step, we moved in lock step with the Colorado Department of Public Health & Environment and federal guidance to reduce exposure for our most vulnerable, those in long-term care facilities and other populations who are more susceptible to COVID-19, through a number of provider care directives.
- We have taken steps to reduce administrative burden on providers through requests for program flexibility from our federal partners.
- We've asked our county partners and all vendors to activate their continuity of operations plans, including work from home capability, to ensure they can answer the phones and serve our members during the state of emergency.
- We have reduced face-to-face engagement requirements where clinically appropriate and enabled telemedicine as an alternative and enacted temporary enhancements to our telemedicine policy to improve overall access to care for our members to further mitigate the spread of the virus.
We are working with our federal partners to secure approval on other accommodations; however, we will need to balance budget constraints with all options before finalizing such decisions. In the interim, you can find up to date information and details on our new webpage:
Colorado.gov/hcpf/covid
.
Thank you to all of you who are on the front lines battling this pandemic to the betterment of our members and all Coloradans. To our county partners, care providers, first responders, sister agencies, Department staff and to all of you, words are inadequate to sufficiently express my sincere appreciation for all you are doing each day to save lives, to keep Coloradans safe and to create access to the HCPF safety net programs and supports that are needed by so many during this state of emergency.
Kim Bimestefer
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The Staff Development Center (SDC) has released a new 5615 forms web-based training. This training provides an overview of 5615 forms and how to calculate a patient payment. The 5615 form is used by Nursing Facilities (NF) to submit a bill to Health First Colorado (Colorado's Medicaid Program). As the eligibility worker, you must document and authorize eligibility dates and patient payments which involves calculating and documenting allowable deductions.
Training Summary:
This web-based training (WBT) will inform the learner of what a 5615 form is and how we use them, give an overview of how to calculate a patient payment, and practice filing out a 5616 form.
This web-based training (WBT) is available in CoLearn:
Please use the direct link provided above to access the training. After clicking the provided link, you will first be directed to the Sign-In page for
CoLearn
,
where you will need to sign in with your login credentials. After signing in, you will then be directed to the Training Details page specific to the training you selected and will need to select
Launch
to begin the training.
Thank you,
The Center
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Redetermination Backlog for Eligibility Sites
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Eligibility sites (counties and Medical Assistance Sites) are experiencing unusually high backlog numbers for Medical Assistance redeterminations due to data entry errors. The Business Process Re-engineering (BPR) Project Learning Session 2 explored business processes and data entry for RRRs and identified guidance to reduce redetermination backlog and maintain timeliness. This guidance pertains to redetermination processing in general and is not specific to potential backlog increases created by the COVID-19 projects for the public health emergency.
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Expanded Hours for Denver Health
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Denver Health's Colorado Medical Assistance Program (CMAP) call center
is expanding its hours to include Saturday 8 a.m. - 12 p.m.
The call center can help all Health First Colorado and CHP+ members update their case and will help all applicants regardless of where they live in Colorado. Members and applicants who call the Department’s Member Contact Center at 1-800-221-3943 and then press “1” will automatically be transferred to CMAP on Saturday mornings.
On weekdays, members and applicants should contact their county of residence or application assistance site for this assistance.
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Substance Use Disorder Benefit Delay
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Given the recent spread and response to COVID-19, the Department has made the difficult decision to delay the effective date of the Substance Use Disorder (SUD) benefits intended through House Bill 18-1136 until January 2021. This six-month delay will enable the Department to free up capacity and budget and allow our partners to respond to the current public health crisis caused by COVID-19. More information is available on the Department's COVID
website
.
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2020 Federal Poverty Level Guidelines
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Recent Memo Series Issued to Counties
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OM 20-049
The purpose of this Operational Memo is to inform Case Management Agencies (CMAs) of temporary operational changes to case management requirements based on Centers for Medicare & Medicaid Services (CMS) guidance for completion of functional eligibility paperwork, including the PMIP in response to the COVID-19 pandemic. This Operational Memo supersedes HCPF OM 20-019: Critical Incident Reporting for COVID-19. Updated information is in a separate section below.
OM 20-048
The purpose of this Operational Memo is to inform providers and CMAs of temporary rate increases in response to the COVID-19 pandemic for some home and community-based services (HCBS) waiver benefits. The service, corresponding rate increase and instructions on how to receive the increase are found below.
OM 20-047
The purpose of this Operational Memo is to inform Consumer Directed Attendant Support Services (CDASS) participants and CMAs of temporary changes to allow payments for sick time during the COVID-19 pandemic.
OM 20-046
The purpose of this Operational Memo is to inform Providers and Case Management Agencies of additional temporary changes in response to COVID-19 pandemic to HCBS waiver benefits and services offered through Health First Colorado. The updates and changes are in bold in the chart below. The Department is requiring all HCBS waiver providers to modify operations in response to health concerns related to the COVID-19 pandemic. Providers shall modify their operations to follow the most recent guidance from the Centers for Disease Control (CDC), the Colorado Department of Public Health and Environment (CDPHE) and the President’s Coronavirus Guidelines for America.
OM 20-045
The purpose of this Operational Memo is to inform Single Entry Points (SEPs), Community Centered Boards (CCBs) and CMAs of temporary operational changes to case management requirements for issuing a Notice of Action (LTC-803) for a member’s functional eligibility in response to the COVID-19 pandemic
OM 20-044
The purpose of this Operational Memo is to inform CMAs of Critical Incident Reporting (CIR) changes to the Benefits Utilization System (BUS), and to outline case manager reporting, service coordination and monitoring requirements for COVID-19. This Operational Memo supersedes HCPF OM 20-022: Case Management Additional Operational Changes in Response to COVID-19. Updated information is in a separate section below.
OM 20-042
The purpose of this Operational Memo is to provide guidance from the Business Process Reengineering (BPR) Project Learning Session to eligibility sites regarding RRR business processes.
OM 20-041
The purpose of this Operational Memo is to inform all County Departments of Human/Social Services, Single Entry Points (SEP) and Healthy Communities contractors that the Department is transitioning from wet signatures on all contracts to electronic signatures for all Department Contracts effective immediately. The program is called DocuSign and requires that each agency provide the Department with the email address for your agency's authorized Signor.
OM 20-037
The purpose of this Operational Memo is to inform CCBs and SEPs of temporary changes to administrative requirements within the Fiscal Year 2019-20 CCB and SEP contracts, in response to the COVID-19 pandemic.
OM 20-036
The purpose of this Operational Memo is to inform HCBS providers and CMAs of the temporary suspension of in-person inspections for the Home Modification and Home Accessibility Adaptation benefits on the Brain Injury (BI), Children’s Extensive Supports (CES), Community Mental Health Supports (CMHS), Elderly, Blind, and Disabled (EBD), Spinal Cord Injury (SCI), and Supported Living Services (SLS) waivers, as well as the temporary suspension of in-person inspections for Individual Residential Support Services—Host Home (IRSS—Host Home) settings during the COVID-19 pandemic.
OM 20-035
The purpose of this Operational Memo is to inform providers and CMAs of guidelines that shall be followed in residential settings in response to the COVID-19 pandemic, including actions necessary where there is a suspected or confirmed case of the COVID-19 illness.
OM 20-034
The purpose of this Operational Memo is to inform CMAs of modifications to the temporary operational changes for face-to-face member contact and assessment authorizations.
OM 20-033
The purpose of this memo is to advise county departments of human/social services and Medical Assistance 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 20-031
The purpose of this Operational Memo is to inform providers and CMAs of temporary changes to the HCBS Non-Medical Transportation (NMT) benefit.
OM 20-028
The purpose of this memo is to advise County Departments of Human/Social services and Medical Assistance sites of income changes to the Health First Colorado Buy–In Medicaid Program for Children with Disabilities (CBwD). Please share this memo with anyone who works with this program.
OM 20-027
The purpose of this Operational Memo is to inform CMAs of temporary changes in response to the COVID-19 pandemic to signature requirements for member paperwork.
OM 20-026
The purpose of this Operational Memo is to inform Nursing Facilities (NF) and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID) of temporary operational instructions for acceptable billing practices related to delays in receipt of 5615 forms from eligibility sites during the COVID-19 pandemic.
OM 20-025
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.
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IM 20-018
The purpose of this Informational Memo is to inform CMA, CCB, Individuals with Intellectual and I/DD and their families and advocates of clarification on Frequently Asked Questions (FAQ) regarding Developmental Disability and Delay Determinations for individuals with co-occurring I/DD or Neurological conditions and Mental Health.
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Health First Colorado Eligibility Email Address Change
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When the Department migrated to gmail in January, the email address for the Health First Colorado Eligibility inbox changed. The new email address is
hcpf_medicaid.eligibility@state.co.us
. If you sent an email to the old email address and have not received a response, please re-send your message to the new email address.
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The U.S. Department of Health and Human Services Office of Inspector General is alerting the public about fraud schemes related to COVID-19.
Scammers are offering COVID-19 tests to Medicare beneficiaries in exchange for personal details, including Medicare information. However, the services are unapproved and illegitimate.
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Economic Impact Payment Resource for Non-Filers
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The Internal Revenue Service (IRS) asks for your assistance getting the word out about Economic Impact Payments. Many people who don’t normally file a federal tax return are eligible to receive a payment, including many with little or no income. This is a very difficult group to reach and the IRS asks for your help to spread the word about these payments as far as possible. Particularly at this difficult time, payments of $1,200 or more can make a world of difference for these at-risk families. The IRS encourages people to come into a
special tool
to do a quick sign-up, particularly lower-income households.
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Hospital Transformation Program (HTP) Update
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HTP application delay
In light of COVID-19 pandemic,
an email communication
was sent to hospitals on March 17 regarding the Department of Health Care Policy & Financing 's (the Department) decision to delay the Hospital Transformation Program (HTP) application deadline of April 30 until a future date, to be announced. Additional information can be found in the linked communication. Although the application deadline has been delayed, the Department continues to work with the CMS toward obtaining approval for all components of the HTP in advance of the target waiver implementation date of October 2020.
Update on federal authorities
The Department continues to engage in discussions with CMS and is working toward obtaining approval for all components in advance of the target waiver implementation date of October 2020.
Hospital Index and Prometheus dashboard update
The Department is in the process of completing a refresh of the data for the Prometheus dashboards and recalculating Hospital Index scores. This is not a refresh that will be used for the baseline of the HTP, but rather our regular annual update to the data. No action is required from hospitals regarding this refresh and update.
For additional information, we encourage stakeholders to visit
the
HTP website
as well as read past editions of the HTP Newsletter and HTP communications
in our online archives
. Please contact
Courtney Ronner
, Hospital Relations and Communication Manager, with any questions.
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The Department is hosting three webinars this Friday, May 1 for long-term services and supports (LTSS) stakeholders and providers about COVID-19. The webinars will consist of new information and responses to questions that came in over the past week.
The webinars are limited to 500 attendees and the phone line is limited to 300 callers, so we ask that you please only attend the webinar that most relates to you. You can listen and ask questions using the webinar link only.
We'd like to thank you for consistently engaging with us as the pandemic continues, and for your flexibility and understanding during this time.
Disability Community
Date and Time:
Friday, May 1, 2020
10:30 a.m. - 11:30 a.m. MST
Webinar Call-in Information:
Local: 720-279-0026
Toll Free: 1-877-820-7831
Participant Code: 303146#
ALL HCBS and PACE Providers and Case Management Agencies
Date and Time:
Friday, May 1, 2020
12 p.m. - 1 p.m. MST
Webinar Call-in Information:
Local: 720-279-0026
Toll Free: 1-877-820-7831
Participant Code: 303146#
Nursing Facilities and Intermediate Care Facilities
Date and Time:
Friday, May 1, 2020
2 p.m. - 2:45 p.m. MST
Webinar Call-in Information:
Local: 720-279-0026
Toll Free: 1-877-820-7831
Participant Code: 303146#
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The Hospital Backup Unit (HBU) program supports qualified skilled nursing facilities in providing
hospital
level care to clients who are ventilator dependent, have complex wounds, or have medically complex needs.
If a county department of human/social services receives a referral for the Hospital Backup Unit (HBU) program, they can reach out to their Single Entry Point (SEP) and
Heleena Hufnagel
at the Department if help is needed with documentation, coordination with the family, or other necessary steps.
Often, HBU placements will not occur until after financial approval is verified. Prioritization of these referrals is important to help move them from Intensive Care Unit placements to a skilled nursing facility.
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Onwardco.org
can help connect Coloradans with services, funds and jobs during the COVID-19 pandemic. This resource is the result of collaboration with the Governor’s Office, state agencies, community partners and Bitwise Industries. Please visit the website and share with anyone who is struggling, or may need the help:
Onwardco.org
.
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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 take place 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 (MSB).
This does not take the place of public testimony at the MSB meeting and anyone who wishes is invited to come to the meeting to address the Board directly.
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County Grants & County Incentives Programs
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Electronic Signatures for County Contracts
The Department is transitioning from physical signatures on all contracts to electronic signatures for all Department contracts effective immediately. The program is called DocuSign and requires each agency provide the Department with the email address of your agency's authorized Signor.
This means physical signatures will not be required for the FY 20-21 County Incentives contract. The Department will reach out in the coming months with specific instructions for county human/social services departments for next year's contracts.
FY 2019-20 County Incentive Program
New Resources
- Monthly Aggregate data for the Food Security Incentive be found on the County Admin webpage under "Incentives Program Data"
- March Case Maintenance Data reports have been posted to the County Admin webpage under "Incentives Program Data"
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FY 2019-20 County Grant Program
- If you need to reschedule your virtual Q3 check in, please reach out to the County Team.
- Report Out Reschedule: The Q4 Year End Report Out will be June 24
MA Supervisor Backlog Targeted Grant
- Please submit monthly progress reports so we can track outcomes and expenditures.
- If there are counties that haven’t spent their MA supervisor funding, let us know so we can reallocate that to others that do.
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Timeliness for March 2020
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Timeliness for all Medical Assistance
applications
was measured at
93.09 percent
.
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Timeliness for all Medical Assistance
redeterminations
was measured at
97.58 percent
.
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Department Contacts & Resources
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Colorado Dept. of Health Care Policy & Financing
(303) 866-2993 | 1570 Grant Street, Denver, CO 80203
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