Wednesday, February 28, 2018

Latest from the CO Dept. of Health Care Policy & Financing (HCPF)

  • At a Glance - February 2018
  • 2018-19 Primary Care Fund Agency Application Review Meeting, Thursday, March 1, 2018, 10:00 am – 12:00 pm,1570 Grant St., Denver, CO 80203 - Palms Conference Room
  • Stakeholder Conference Call-In Information: 1-877-820-7831 (U.S. Domestic) or 1-720-279-0026 (Local/International) - Dial room number: 155811# - Wait to be added to conference. Click here for PowerPoint presentation.

Friday, February 16, 2018

Congress Passes Funding Agreement for NHSC!

"With the successful passage of the Continuing Resolution (CR), we are very grateful for your work securing a two year extension to the National Health Service Corps (NHSC), Community Health Centers, and the Teaching Health Centers programs, and the five year reauthorization of the Maternal, Infant, and Early childhood Home Visiting Program.

This action proves that your work has made a difference, and you can be sure that ACU will continue to work to strengthen the NHSC into the future. While we support and applaud Congress for their bipartisan effort on this spending deal, we recognize that significant disparities continue to exist in healthcare access across the country. For example, even though last year more than 10,000 National Health Service Corps members served 10 million people in every state and territory, it would still take an additional 27,000 providers just to meet the existing shortages. Furthermore, the annual budget for the NHSC as it stands is an amount sufficient to fund less than 40% of the applicants willing to serve in areas of provider shortages.

The NHSC has a 40 year track record of success and we applaud Congress for its action to ensure that this crucial program can continue into the future. ACU will continue to seek out additional opportunities to strengthen the National Health Service Corps even further and to continue to improve the health of millions of Americans nationwide.'

Latest from the CO Dept. of Health Care Policy & Financing (HCPF)

Colorado interChange: Week of February 15, 2018
As the Colorado interChange moves toward normal operations, we'll be broadening the focus of this newsletter to bring you hot topics and useful information on a larger variety of issues related to Health First Colorado (Colorado's Medicaid Program) and other initiatives from the Department of Health Care Policy & Financing (the Department). We'll continue to focus on issues we believe your members we be discussing and resources to share. 

Provide Buzz on the Colorado interChange:
  • FAQs for multiple service locations are now available on the Department's website. If you have questions about requirements for providers with multiple service locations or how to enroll and bill for service locations separately, check out the FAQs here.
Other Topics
  • If you haven't had the chance already, take a moment and meet our new executive director. Kim Bimestefer has an extensive background in health care and has been leading the Department since her appointment by Gov. John Hickenlooper in January.
  • The next iteration of the Accountable Care Collaborative (ACC) is scheduled to begin July 1, 2018. The goals of the next phase are to improve member health and reduce costs. In November 2017, the Department announced the awards for the seven Regional Accountable Entity (RAE) contracts. The Department has made available the proposals from each of the awarded entities on

    Recorded Webinars Online Now
ACC Phase II Implementation Process Overview

ACC Phase II: Provider Contracting (What Providers Need to Know)

Quick guides and webinars can help with Provider Web Portal questions
Quick guides and webinars developed to support you in using the new Provider Web Portal and in getting questions answered are constantly being updated on the Colorado Department of Health Care Policy and Finance website. While these quick guides aren't a substitute for provider-specific questions that should be directed to the Provider Services Call Center (1-844-235-2387), they do provide help on a variety of key topic areas and as well as other areas on which providers have indicated they need addition information.
The Department is always interested in your feedback on other educational resources that could be added. You can provide your Regional Field Representative with ideas for additional educational materials as well as local training support topics.

Thursday, February 8, 2018

Congress Closes in on a Funding Agreement for the NHSC!

"Thank you for your tireless efforts in our campaign to ensure long-term funding for the NHSC and other vital health programs like Community Health Centers and Teaching Health Centers.

Over 10,000 emails and hundreds of tweets were directed to Members of Congress and had a significant impact:

Last night, the House passed a Continuing Resolution (CR) to extend non-defense spending until March 23. The House bill contains a two-year extension to health programs whose funding expired over 125 days ago, including The National Health Service Corps, Community Health Centers, Teaching Health Centers.

This is promising news, however the House CR has been amended in the Senate. The Senate Bill also contains an extension for the above mentioned health extenders but negotiations over the amount of funding for these programs are still underway. The draft currently includes a funding increase for some programs and level funding for the NHSC (page 323).

The Senate bill will be voted on this morning and head back to the House again for another vote.

While we remain optimistic that an agreement is close at hand, at this point nothing is certain. Please keep up your tireless advocacy and encourage your colleagues to do the same!"

Source: Association of Clinicians for the Underserved. 

Wednesday, February 7, 2018


2/7/18 CHIP Coalition Update:

"U.S. Senate leaders announced an agreement to fund the federal government, which must pass by midnight tomorrow to avoid another government shutdown. The U.S. House passed a stopgap funding bill yesterday, which will be struck and replaced by the Senate deal. Therefore, there will need to be a Senate vote and then a House vote on the Senate deal before it could be signed by the President.

The Senate agreement is rumored to include an additional 4 years of funding for CHIP, for a total of 10 years of funding. The deal is also rumored to include 2 years of funding for Community Health Centers and 5 years of funding for MIECHV/home visiting. It is also rumored to include cuts to the Prevention and Public Health Fund.

You can read more about the agreement in these articles from Vox, the New York Times, and Politico."

Latest from the CO Dept. of Health Care Policy & Financing (HCPF)

Colorado interChange: Week of January 29, 2018
As the Colorado interChange moves toward normal operations, we'll be broadening the focus of this newsletter to bring you hot topics and useful information on a larger variety of issues related to Health First Colorado (Colorado's Medicaid Program) and other initiatives from the Department of Health Care Policy & Financing (the Department). 
Provider Buzz
Here's a look at hot topics for providers and others:
  • Providers are reminded to verify coverage under Benefit Details (example shown here) on the Provider Web Portal before rendering services. The Alternative Benefit Plan (ABP) is an extended plan which must be accompanied by Medicaid State Plan (TXIX) coverage. If the member does not have TXIX coverage, they are not eligible for services and claims will be denied for EOB 3261 - "The procedure code currently is not a benefit for date of service billed. Refer to the CPT or the HCPCS listing for valid procedure codes." For detailed, step-by-step instructions on verifying member eligibility, refer to the Verifying Member Eligibility - Provider Web Portal Quick Guide, available under the Quick Guides section on the interChange Resources web page.
  • For Tax Year 2017 providers may receive two 1099 Miscellaneous Income (1099-MISC) forms from the State of Colorado due to implementation of the Colorado interChange in March 2017. Specifically, if a provider was enrolled in Colorado Medicaid for the period January - February 2017, they will receive a 1099-MISC form from the State of Colorado, Office of the State Controller. Providers enrolled in Colorado Medicaid for the period March - December 2017, will receive a 1099-MISC form from the Department of Health Care Policy and Financing. The amounts shown on the 1099's are what the Department has reported to the IRS.

Other hot topics from the Department

News You Can Use
New Fee Schedules and instructions available now
An updated and downloadable versions of the July 2017 Fee Schedule Data File (1/18) and the July 2017 Fee Schedule Instructions (1/18) have been posted to the Provider Rates & Fee Schedule web page, under the Health First Colorado Fee Schedule drop-down section.

Updated information includes downloadable data files for all updated fees.