At a Glance is a Department of Health Care Policy & Financing (HCPF) 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 our website. Thank you for your interest!

Navigating Federal Funding Threats to Medicaid Concurrent with State Budget Concerns

Concerns about federal threats to Medicaid funding are on everyone’s mind. Here are four tools that will help our partners get their arms around these threats to Colorado, which could impact members and benefits, and climb well above $1 billion General Fund, depending on which options Congress passes. To put that figure in perspective, HCPF’s projected fiscal year 2024-25 General Fund budget is $5.2 billion, meaning a $1 billion federal cut would represent about a 20% impact.

1. We crafted two CO Federal Medicaid Funding Threats tools (see the links in the Federal Resources box on the right at the top of the page). One version helps individuals understand funding cut options under consideration to achieve the Congressional Energy and Commerce Committee $880 billion target reduction. The version includes budget reduction projections at the federal level over 10 years, largely provided by the Congressional Budget Office (CBO) and also provides an annual Colorado General Fund budget reduction impact estimate. The second version of the tool leverages the same base information but removes the federal budget reduction estimates. 
2. To help individuals understand the impact to their local community, HCPF has made available county by county fact sheets with enrollment information, total population in each county covered by Health First Colorado (Colorado’s Medicaid program) or Child Health Plan Plus (CHP+), total Medicaid funding for members covered in that county and top provider types receiving Medicaid funding by county. 
3. The Medical Assistance Coverage Fact Sheet (see the first link under Overviews and Fact Sheets) answers many questions coming into HCPF, such as: income requirements for Medicaid, CHP+ and to secure Connect for Health subsidies; Medicaid mandatory versus optional benefits; federal and state funding splits by populations, and more.
4. HCPF’s Annual Report is on our website, providing a lot of specific information on our safety net coverage specific to fiscal year 2023-24, such as populations covered, payments to providers, federal funding and more.  

HCPF is closely monitoring emerging federal revenue reduction or budget cut concepts that may impact Medicaid, our state budget and our members. We will keep you informed as the landscape evolves. Time for HCPF and the state to respond to Federal rule, policy and funding changes may be more challenging due to the recent communication by the U.S. Department of Health and Human Services (HHS), indicating that they are rescinding the policy on Public Participation in Rule Making (Richardson Waiver) and re-aligning HHS’s rule-making procedures. We thank you in advance for your collaboration given this reality. 

Colorado Medicaid Sustainability Efforts

Unique to Colorado is the combination of state constitutional provisions impacting our balanced budget requirement as well as revenue limitations propelled by Colorado’s Taxpayer Bill of Rights (TABOR). Accordingly, reductions to Federal Medicaid funding may disproportionately impact Colorado’s Medicaid and CHP+ benefits, coverage, eligibility requirements and provider reimbursements. 

The Joint Budget Committee (JBC) is in the process of making very difficult balancing decisions as they tackle a $1 billion budget deficit challenge, though that is subject to change with the next revenue forecast scheduled for March 17. HCPF’s budget represents about one-third of the state’s budget and moves at a historic cost trend of about 7-8% annually, while state General Fund revenues move at a rate of about 3-4% annually. The HCPF Medicaid Sustainability Framework seeks to organize emerging budget reduction concepts and strategies to enable the thoughtful navigation of Medicaid’s multi-year, fiscal challenge while fostering partnership and collaboration to achieve the shared goal of mitigating draconian Medicaid and CHP+ cuts due to our state budget challenges. 

Our February forecast update to the JBC included an increase for the current fiscal year 2024-25 ($114 million) and fiscal year 2025-26 ($83 million) based on our most updated insights. This forecast is our best projection of our expenditures for Health First Colorado and CHP+ services and will inform this month’s JBC’s figure setting decisions. The Office of State Planning and Budgeting (OSPB) sent the JBC a letter including potential HCPF budget reduction offsets for the JBC's consideration, given our forecast need for additional funds. The balancing proposals total $22.8 million General Fund in fiscal year 2024-25 and $132.5 million General Fund in fiscal year 2025-26. Ninety-six percent of HCPF’s budget goes to pay health care providers rendering services to our members, while 4% goes to cover HCPF’s administration costs, making Health First Colorado the most efficiently run health plan in the state. More information is available on our budget website and Legislator Resource Center.

HCPF released its annual, statutorily required Hospital Transparency reports on January 15. These reports measure Colorado hospital profits, costs, expenses, the level of community benefit that tax-exempt hospitals offer their communities in lieu of paying taxes, and more. The hospital reports and other materials have been posted on the Hospital Reports Hub website. Key findings from these reports, including Hospital Financial Transparency, Colorado Healthcare Affordability and Sustainability Enterprise (CHASE), and Hospital Community Benefit Accountability, were reviewed during HCPF’s Hospital Transparency Reports Webinar on February 13. Recordings of this event are available in English and Spanish, as is the slide deck. 2025 Hospital Reports Webinar - English/ASL; 2025 Hospital Reports Webinar - Spanish; 2025 Hospital Reports Webinar - Slide Deck.

I want to thank our many partners who serve our members. Your insights and collaboration are important as we navigate the state’s fiscal challenges in combination with the emerging Federal threats to Medicaid. We thank you in advance for your partnership on both these fronts. We are in this together!

HCPF Hospital Transparency Reports Webinar:

Thank you to all who attended our recent Hospital Transparency Reports Webinar. These reports measure Colorado hospital profits, reserves, costs, expenses and the level of community benefit that tax-exempt hospitals offer their communities in lieu of paying taxes. Hospitals are essential pillars within the communities they serve. These reports provide insight into hospital financial health. The reports and materials are posted on our website. 

Telehealth Remote Monitoring Grant:

Senate Bill 24-168 created the Telehealth Remote Monitoring Grant Program which will award up to $500,000 to eligible rural outpatient health care facilities via five (5) $100,000 grants. Grant funds are to be used for implementing telehealth remote monitoring for outpatient clinical services and must be used to: 

• Pay for the acquisition costs of telehealth remote monitoring equipment and devices. 
• Train staff to use, assess, and monitor telehealth remote monitoring equipment and devices.

The grant will go to eligible rural health care facilities (hospitals, rural health centers, or Federally Qualified Health Centers [FQHC’s]) that provide outpatient clinical services in Colorado and are located in a designated rural county or a designated Health Professional Shortage Area (HPSA). 

The purpose of the grant program is to enable rural Coloradans to benefit from telehealth remote monitoring services. Access to these services results in better health outcomes and saves money, time, and energy spent on obtaining health care.

Telehealth remote monitoring services will provide cost savings for the Health First Colorado (Colorado’s Medicaid program) system by improving rural access to primary care and helping prevent unnecessary trips to the emergency room. In addition, these services are a crucial step toward reducing health disparities and achieving health equity in Colorado. 

Important dates:

Let us know if you intend to apply by March 30, 2025, by emailing hcpf_rmg@state.co.us.

The Request for Applications will open on March 31, 2025, and close on May 1, 2025.

Email address for questions/comments re the Telehealth Remote Monitoring Grant: hcpf_rmg@state.co.us



Visit the HCPF website for more information about the program and to learn how to apply for the grant. 

Feedback Requested on County Administration Rule Changes:

Beginning in December 2024, HCPF began to solicit input on the County Administration Rules. HCPF's County Administration rules govern the Medical Assistance fiscal and programmatic operations of the county departments of human/social services (counties). These rules set standards for fiscal and program compliance, customer service, non-discrimination and accessibility, and more. These rules do not apply to eligibility determinations or actions taken in the eligibility determination system. 

We are encouraging providers, advocates, members, and the general public to provide feedback on the suggested changes to the rules. Interested parties can provide feedback by providing written comments or by participating in a stakeholder meeting. A full list of stakeholder meetings, a copy of the suggested changes to rules, and the comment form are on the county rulemaking webpage.  

Bariatric Surgery Rule Revision Stakeholder Meeting March 13: 

Thank you to everyone who participated in the first stakeholder meeting on Jan. 23. We appreciate your valuable feedback and invite you to join us for the second meeting in this series:

Meeting 2: Thursday, March 13, 2025

Time: 9:30 a.m. to 12:30 p.m.

Location: Virtual via Zoom (Register in advance)

During this meeting, HCPF staff will continue discussions on revising the bariatric surgery rule. Building on feedback from the Jan. 23 meeting, staff will present refined language changes and facilitate further discussion on key areas of the rule. Stakeholders will have the opportunity to provide additional input and share any supporting documentation or research.

We encourage attendees to review the current rule and the recording of the Jan. 23 meeting before participating. 

Meeting Accommodation and Language Access Notice: Auxiliary aids and services for individuals with disabilities and language services for individuals whose first language is not English may be provided upon request. Please notify us at HCPF_Stakeholders@state.co.us at least one week prior to the meeting to make arrangements.

Las ayudas y servicios auxiliares para individuos con discapacidades y servicios de idiomas para individuos cuyo idioma materno no sea inglés pueden estar disponibles por solicitud. Comuníquese con nosotros a HCPF_Stakeholders@state.co.us al menos una semana antes de la reunión para hacer los arreglos necesarios.

Provider Services Call Center Vendor Transition: 

On May 1, 2025, HCPF will transition the management of the Provider Services Call Center from Gainwell to OptumInsight (Optum).  

What is changing: 

• The Provider Services Call Center phone number will change. HCPF will announce the new phone number closer to the transition.  
• This vendor transition will add enhancements to the provider experience, including: 
• Providers will be offered an after-call survey to provide valuable feedback about their call. 
• Providers will be able to use their National Provider ID or the Health First Colorado ID. 

What is not changing: 

• Gainwell will continue as the vendor for the Colorado interChange and the Provider Web Portal, meaning many provider-facing functionality and processes will stay the same, including: 
• Provider Web Portal general functionality and password resets (excluding Secure Correspondence) 
• Provider Payment and Remittance Advice 
• Provider Enrollment and Revalidation 
• Alternate Call Center Supports (Member, Pharmacy, CCM, RAE). For a complete list of assistance resources, visit the Provider Contacts webpage. 

Visit the Colorado Medicaid Enterprise Solutions (CMES) Transition webpage for more information. 

Reminder: Members and Applicants Should Request Emergency Medicaid Services/Reproductive Health Care Services (EMS/RHCS) in addition to Cover all Coloradans (CAC):

HCPF wants to ensure that Health First Colorado (Colorado Medicaid) applicants and members are encouraged to request the full range of benefits available to them. Cover All Coloradans (CAC) ends at age 19 or one year after a pregnancy ends. To help CAC members avoid losing Emergency Medicaid and Reproductive Health Care Services when they are no longer eligible for CAC, we would like to remind you to encourage potential applicants or current members to request Emergency Medicaid (EMS) and Reproductive Health Care Services (RHCS) benefits. People can be enrolled in both CAC and EMS/RHCS at the same time. If you happen to be assisting any potential applicants or current members with their coverage, you are encouraged to pass along the following messages:

• Current Cover All Coloradans members can also request EMS/RHCS at any time through PEAK or with the help of their county.
• Applicants who are applying for Health First Colorado and may qualify for Cover all Coloradans can also request EMS/RHCS at the time of application.

Resources:

Emergency Medicaid and Reproductive Healthcare Services Webpage

Emergency Medicaid Memo Guidance

Cover All Coloradans Webpage

Cover All Coloradans FAQ

Cover All Coloradans Memo Guidance

County Contact Information

Contact: hcpf_coverallco@state.co.us

Recordatorio que los miembros y solicitantes deben solicitar Servicios de Medicaid de Emergencia/Servicios de Asistencia de Salud Reproductiva (EMS/RHCS) además de Cover All Coloradans (CAC).

El Departamento de Políticas y Financiamiento de Atención Médica (Department of Health Care Policy and Financing, HCPF) quiere asegurarse de que los solicitantes y miembros de Health First Colorado (Medicaid de Colorado) sean animados a solicitar la gama completa de beneficios disponibles para ellos. Cover All Coloradans (CAC) finaliza a los 19 años o un año después de que termine un embarazo. Para ayudar a los miembros de CAC a evitar la pérdida de Servicios de emergencia de Medicaid y atención de salud reproductiva cuando ya no sean elegibles para CAC, a nosotros nos gustaría recordarle a usted que anime a los posibles solicitantes o miembros actuales a solicitar los beneficios de Medicaid de Emergencia (EMS) y Servicios de Atención Médica Reproductiva (RHCS). Las personas pueden ser inscritas tanto en CAC y en EMS/RHCS al mismo tiempo. Si por casualidad usted está asistiendo a posibles solicitantes o miembros actuales con sus coberturas, a usted se le anima a transmitir los siguientes mensajes:

• Los miembros actuales de Cover All Coloradans también pueden solicitar EMS/RHCS en cualquier momento a través de PEAK o con la ayuda de su condado.
• Los solicitantes que están solicitando Health First Colorado y que pueden calificar para Cover All Coloradans también pueden solicitar EMS/RHCS en el momento de la solicitud.

Fuentes:

Página web de Medicaid de emergencia y servicios de atención médica reproductiva

Guía de memorándum de Emergencia de Medicaid

Página web de Cover All Coloradans

Preguntas frecuentes de Cover All Coloradans

Guía de memorándum de Cover All Coloradans

Información de contacto del condado

Contacto: hcpf_coverallco@state.co.us

Member Correspondence Improvements:

HCPF is holding a series of quarterly virtual stakeholder meetings to present information about ongoing improvements to member correspondence.

At the meetings, HCPF staff will share

• updates on improvements being made,
• timelines for making changes,
• plans for future letter improvements, and
• opportunities for stakeholders to stay involved.

Attendees will be able to submit questions to be answered live when possible. Frequently asked questions will be posted on the Member Correspondence Improvements website following the meeting. Attendees will also be able to submit feedback via Google form for two weeks following the meeting.

The meetings will be in English and Spanish. ASL interpretation will be provided.

Meeting dates and times: 

• Thursday, April 17, 2025, 12 to 1 p.m.
• Thursday, July 17, 2025, 12 to 1 p.m.
• Thursday, Oct. 16, 2025, 12 to 1 p.m.

Please register for the meetings in advance. After registering, you will receive a unique link to join the meeting. For those who cannot attend the meetings, you may request a recording.

Meeting Accommodation and Language Access Notice: Auxiliary aids and services for individuals with disabilities and language services for individuals whose first language is not English may be provided upon request. Please notify the Stakeholder Engagement Section at HCPF_stakeholders@state.co.us at least one week prior to the meeting to make arrangements. 

If you have general questions, please contact the Stakeholder Engagement Section at HCPF_stakeholders@state.co.us for more information. 

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Mejoras de la Correspondencia de los Miembros

Health First Colorado está trabajando para mejorar las cartas de miembros y están planeando cambios basados en los comentarios de miembros y las partes interesadas.

Para aquellos que no puedan asistir, una grabación será compartida después y publicada en la página web de correspondencia de miembros.

Los asistentes también serán capaces de someter comentarios a través de un formulario en línea por dos semanas después de la reunión.

Fechas y horarios de las reuniones: 

• Jueves, 17 de abril de 2025, de 12 - 1 p.m.

• Jueves, 17 de julio de 2025, de 12 - 1 p.m.

• Jueves, 16 de octubre de 2025, de 12 - 1 p.m.

Por favor, registrarse para las reuniones con anticipación. Después de registrarse, Usted recibirá un enlace único para unirse a la reunión. 

Las reuniones serán en inglés y español. Se proporcionará interpretación en lenguaje de señas (ASL, por sus siglas en inglés).

Aviso sobre las adaptaciones y el acceso lingüístico para las reuniones: Ayudas y servicios auxiliares para individuos con discapacidades y servicios de lenguaje para individuos cuya primera lengua no sea el inglés puede ser proporcionado bajo solicitud. Por favor, notifique a la Sección de Compromiso con las Partes Interesadas a HCPF_stakeholders@state.co.us al menos una semana previa de la reunión para hacer los arreglos.

Si usted tiene preguntas generales, por favor comuníquese con la Sección de Compromiso con las Partes Interesadas a HCPF_stakeholders@state.co.us para más información.