At a Glance is a Department of Health Care Policy & Financing (Department) publication that provides information on major initiatives, policy changes and program updates. Feel free to share At a Glance with your colleagues. Find previous editions of At a Glance on the Department website at colorado.gov/hcpf/publications. Thank you for your interest!
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A Message from the Executive Director |
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Affordability Powers Recovery
Through Medicaid and CHP+, HCPF is now providing coverage and services to more than 1.5 million Coloradans, a 21% increase since March 2020. Thank you for your partnership in providing critical services to Coloradans in need.
Covering one in four Coloradans during a fiscal downturn necessitates innovations that prudently control costs and improve health, enabling us to better protect provider reimbursements and member benefits. HCPF administration remains less than 5% of our budget, which is significantly lower than the average commercial carrier administration of more than 13%. Our efficiency enables us to allocate more than 95 cents on every dollar to care.
Our priority innovation opportunities are in the areas of long-term services and supports (LTSS) as well as hospital and prescription drugs. Relative to LTSS, we received partial approval from CMS on our Home & Community Based Services (HCBS) 10% enhanced FMAP proposed spending plan, which was crafted collaboratively with more than 800 stakeholders. We are working with CMS to address their questions before the next round of stakeholder engagement.
In addition to the Hospital Transformation Program that launched in April 2021, we are also releasing hospital reports this month that analyze urban hospital costs, prices and profits as well as the impact of COVID and related federal stimulus on Colorado hospitals.
To lower prescription drug costs, we released the Affordability Module of our new Prescriber Tool in June to empower prescribers with cost insights into drug therapy options. Since one in three Coloradans either cannot fill a prescription, cut pills in half, or skip doses due to cost, this tool helps advance Gov. Polis’ quest to save people money on health care while also controlling Medicaid spend. Colorado is the first state in the nation to provide a shared Prescriber Tool that supports affordability for patients, employers and Medicaid. Via electronic health records (EHRs), 85% of Medicaid prescribers can access this tool to earn value-based payments and be part of the prescription drug affordability solution. The tool also reduces administrative burden and rework for providers and improves service to Medicaid and commercial members through e-prescribing and e-prior authorizations. In that spirit, it is critical that providers collaborate with HCPF to enable and use this new tool. Contact your EHR vendor today to make sure Colorado Medicaid Real-Time Benefit Check transactions are routing. More information on the Prescriber Tool is available on our website.
Register online to join our August 19 virtual Health Cabinet Summit to learn more about the findings in the hospital costs, prices & profits report, updates on our state and federal prescription drug affordability strategy since the release of our January 2021 Reducing Prescription Drug Costs in Colorado Report, the Behavioral Health Administration work, and health equity opportunities. Looking forward to seeing you then!
Kim
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NEMT Update: Intelliride's Statewide Brokerage Ended Aug. 1:
Non-Emergent Medical Transportation (NEMT) is a Health First Colorado (Colorado's Medicaid program) benefit for members who don't have transportation to medical appointments. Last July, the Department expanded its contract with IntelliRide to manage all NEMT trip referrals, scheduling, and claims submission throughout the state.
Local transportation providers and Health First Colorado members expressed concerns about the statewide approach shortly after its July 2020 implementation. The Department evaluated the feedback with IntelliRide and decided to restore the relationship between members and their local community transportation providers for those members outside IntelliRide's original nine-county service area. As a result, IntelliRide no longer serves as the statewide broker for NEMT services effective Aug. 1, 2021.
IntelliRide has reduced its NEMT service area to its original nine-county region --- Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, Jefferson, Larimer, and Weld Counties. As a result, NEMT service outside of IntelliRide’s nine-county region returned to local transportation providers on Aug. 1, 2021.
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New Prescriber Tool for Health First Colorado:
Prescription drugs are the leading contributor to rising health care costs, but that challenge impacts more than just the financials. One in three Coloradans either cannot fill a prescription, cut pills in half, or skip doses because of the cost.
Colorado is the first state in the nation to provide a cohesive Prescriber Tool that achieves this goal for both Medicaid and commercial prescribers. This will save Coloradans money on health care, reduce health care costs for employers and Health First Colorado, while also improving patient health by making prescription drug therapy more affordable and accessible. The Prescriber Tool also reduces administrative burden for providers by making prescription writing easier and reducing rework. Eight-five percent of Health First Colorado's 24,459 prescribers have the real-time benefit check in their electronic health record.
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Colorado COVID-19 Health Care Provider Vaccine Information Toolkit:
In an effort to best organize and make readily available the wide array of health care provider vaccine resources, trainings and materials related to the COVID-19 vaccination program, the Colorado Department of Public Health and Environment (CDPHE) has created the online Colorado COVID-19 Health Care Provider Vaccine Information Toolkit. The toolkit has a variety of robust elements. Please share with your networks.
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Monthly Child Tax Credit Payments Started in July:
Through a recent expansion of the Child Tax Credit (CTC) and Earned Income Tax Credit (EITC) under the American Rescue Plan Act of 2021, more Colorado families are eligible. Starting last month, families can receive up to $300 a month for every child ages 0-5 and $250 a month for every child ages 6-17 living in their household. Families who filed taxes in 2020 may already be receiving these checks or direct deposits.
Families who did not file taxes need to sign up with the IRS to receive this cash-back refund, but do not need earnings to qualify.
The child tax credits do not count as income for eligibility for Health First Colorado, Child Health Plan Plan Plus (CHP+) and other public assistance programs.
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Help Us Get the Word Out! Monthly Tax Credit Resources for Parents & Stakeholders:
This toolkit was created for anyone to use to spread the word that expanded tax credits can help lift up to 40% of Colorado families out of poverty. The toolkit contains English and Spanish language messages, a flyer for distribution in physical settings, and sample newsletter and text message content. Please share with your networks and families who could benefit from these new cash-back resources!
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Colorado COVID-19 Health Care Provider Vaccine Information Toolkit:
In an effort to best organize and make readily available the wide array of health care provider vaccine resources, trainings and materials related to the COVID-19 vaccination program, the Colorado Department of Public Health and Environment (CDPHE) has created the online Colorado COVID-19 Health Care Provider Vaccine Information Toolkit. The toolkit has a variety of robust elements. Please share with your networks.
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Gov. Polis Ends COVID-19 Health Emergency Order:
On July 8, Gov. Polis ended the Health Emergency Executive Orders for COVID-19, rescinded all previous Executive Orders issued due to the COVID-19 pandemic, and signed a Recovery Executive Order to focus only on those measures related to the state's recovery from the COVID-19 pandemic emergency.
The emergency orders impacting Colorado's Medical Assistance programs remain in place. Specifically, the following remains unchanged:
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Federal public health emergency (PHE) mandating continuous coverage, which is anticipated to end Dec. 31, 2021 (additional information is on our PHE planning website at Colorado.gov/phe-planning)
- Executive Order D 2020-068 provisions that provide Medicaid and CHP+ eligibility and enrollment flexibility during the PHE
- Colorado's federal 1135 waiver and Appendix K Emergency Preparedness and Response flexibilities
- 6.2% enhanced FMAP
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Telemedicine Webinar:
HB21-1256, signed by Gov. Polis on May 27, 2021, gives the Department the authority to set rules designed to guide provider entities that operate predominately or solely via telemedicine. To that end, the Department needs to define, identify, and set policy for these Electronic Health Entities (E-Health Entities). In this session, stakeholders will be asked to provide feedback on a proposed definition and its alignment with current telemedicine business models.
Date: Aug. 18, 2021
Time: 3:30 – 4:30 p.m.
After registering, you will receive a confirmation email containing information about joining the webinar.
Please feel free to share this invitation and registration link with others who may be interested in participating.
Staff Contact: For more information contact Betsy Holt, Policy Development Stakeholder Engagement Specialist at betsy.holt@state.co.us or 303.866.2831.
Reasonable accommodations will be provided upon request for persons with disabilities. Please notify Betsy Holt at betsy.holt@state.co.us or the 504/ADA Coordinator at hcpf504ada@state.co.us at least one week prior to the meeting to make arrangements.
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Proposed American Rescue Plan Act Spending Plan for Home and Community-Based Services:
The Department is pleased to announce that the Centers for Medicare & Medicaid Services (CMS) has provided an initial partial approval of its submission of the proposed ARPA HCBS Enhanced Match Spending Plan. To obtain full approval, CMS asked for additional clarification and information on various parts of the originally submitted plan. The Department has responded to CMS' questions and requests and will await full approval prior to presenting a final approved plan to the Colorado Joint Budget Committee (JBC) as soon as can be scheduled, presumably early this fall.
The CMS letter and the Department response letter, in addition to the originally submitted plan which outlines how the state intends to enhance, expand, or strengthen HCBS, are on the Department's website.
In preparation for the JBC presentation, the Department invites all interested stakeholders to provide their feedback and input on the current, further refined plan submitted to CMS. Topics discussed will include a review of the plan at a high level, current priorities, updated timelines, and an overview of project implementation and fund distribution.
Please join us at one of the following opportunities:
General Stakeholder Meetings:
Meeting 1
Monday, Aug. 23, 2021
1:30 - 3 p.m., MT
Webinar ID: 822 5533 9128
Passcode: 809390
Join by Phone:
720-707-2699 or (Toll-free)877-853-5257
and
Meeting 2
Tuesday, Aug. 24, 2021
2 - 3:30 p.m., MT
Webinar ID: 822 5533 9128
Passcode: 809390
Join by Phone:
720-707-2699 or (Toll-free)877-853-5257
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Targeted Stakeholder Meeting - Members, Families, and Advocates:
Thursday, Aug. 26, 2021
9 - 10:30 a.m., MT
Webinar ID: 822 5533 9128
Passcode: 809390
Join by Phone:
720-707-2699 or (Toll-free)877-853-5257
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Background
The HCBS provision in the American Rescue Plan Act, section 9817, will increase the Federal Medical Assistance Percentage (FMAP) for Medicaid HCBS spending by 10 percentage points from April 1, 2021 through March 31, 2022. Over the next three years, the Department will use this additional infusion of short-term funds to increase access to HCBS for Medicaid beneficiaries - benefits that provide older adults and individuals with disabilities, including those with behavioral health needs, with critical services in their homes and communities.
In alignment with federal guidance, stakeholder feedback, and priorities articulated in the legislation from the Joint Budget Committee (JBC), the Department has crafted a plan that:
- Supercharges existing initiatives and state priorities;
- Supports the COVID-19 response and recovery for the providers, members, and families relying on Colorado's HCBS system;
- Fosters innovation & long-term transformative change; and
- Increases quality & fiscal stewardship to improve health care equity, access, and outcomes for the people we serve.
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Reasonable accommodations will be provided upon request. Please notify John Barry at 303-866-3173 or the 504/ADA Coordinator at least one week prior to the meeting to make arrangements for persons with disabilities. Auxiliary aids and services for individuals with disabilities and language services for individuals whose first language is not English may be provided upon request.
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State Health Officials Release COVID-19 Back-to-School Guidance from CDC:
On July 20, 2021, Colorado Department of Public Health and Environment (CDPHE) released new P-12 school guidelines as teachers, students, and staff prepare for the 2021-2022 school year. CDPHE will adopt and clarify school guidance released this month by the Centers for Disease Control and Prevention (CDC), and is providing a practical guide for schools, parents, and students on how to operationalize the CDC guidance in the state’s education settings.
Colorado has adopted a guidance model designed to empower local public health and local leaders to protect their communities using the mitigation strategies most appropriate to local conditions. The guidance does not constitute statewide requirements, but instead outlines evidence-based best practices for local governments and schools to manage the next stage of the pandemic.
In addition to vaccination, the state continues to recommend a layered approach of best practices to COVID-19 prevention. These best practices are described in detail in the Back to School Roadmap, and include ventilation, maximization of outdoor activities, mask wearing, testing, spacing, cohorting, symptom screening, cleaning and disinfecting, and handwashing.
Colorado’s best defense against COVID-19 is increased vaccinations, as vaccination prevents disruptions to in-person learning. Vaccines have been highly successful at preventing transmission, infections, and deaths from COVID-19. The back-to-school guide includes ways that CDPHE can partner with schools and school districts to host vaccination clinics and increase our defense against this virus. Children’s risk of contracting COVID-19 is greatly reduced when they live in a household where all eligible individuals are fully vaccinated, even if the children are not yet eligible for vaccination. Any school or school district interested in hosting a vaccination clinic should complete the Vaccination Event Request Form to request more information about vaccination partnerships and outreach.
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