ClinicNET Affiliate Staff: Don't forget to compete our annual affiliate survey!

Are you a ClinicNET affiliate? If you have not done so already, please complete our 2014 ClinicNET Affiliate Survey by noon on Monday, January 12th. All respondents will be entered into a drawing to win 1 of 2 $25 Amazon.com gift cards! Your participation will help us understand our impact, your needs and how we can improve our technical assistance, outreach, education & advocacy work.  Thank you in advance for your feedback!

Live Webcast – Meaningful Use & Audit Survival Guide

“Join PrivaPlan for an educational webcast on January 15th at 12:00pm where they’ll cover Meaningful Use (MU) attestation preparation, audit preparation and audit survival, and last but not least, how to prepare for MU in 2015. PrivaPlan has helped hundreds of eligible professionals and hospitals successfully attest to MU over the last 4 years, as well as pass Medicare and Medicaid audits. PrivaPlan even successfully helped appeal negative audit determinations.

Click here to register and view the agenda. If you register before December 31, 2014, you will receive $30 off retail ticket price of $249. Use promocode: GETTHEWORM.” [Source: PrivaPlan]

Network Adequacy Report and Stakeholder Meeting – Colorado Department of Regulatory Agencies

“The link to the network adequacy report and maps for the individual market were posted December 15th; because of the number of maps (and size of the file), the documents were posted separately, but can be found at: http://www.dora.colorado.gov/healthinsurance.

The Initial Network Adequacy Stakeholder Meeting will be held Tuesday, January 20, 2015, from 10:00am – 12:00pm at the 19th Floor Conference Room of the Civic Center Plaza building (address: 1560 Broadway, Denver CO 80202). The meeting will also be available via webinar (the details to access will be sent in future correspondence); we expect a high turn-out, and will have limited space available, so we HIGHLY encourage you and/or staff members to participate online when possible.” [Source: DORA]

Provider Recruitment for Chronic Pain Disease Management Program

“The Accountable Care Collaborative (ACC) invites you to participate in a new Chronic Pain Disease Management Program. Modeled after the Project ECHO (Extension for Community Healthcare Outcomes) program developed in New Mexico, the Chronic Pain Management Program leverages cutting edge telehealth technologies to connect PCMPs to specialists. PCMPs consult directly with specialists regarding client cases and learn best practices for treating clients with a variety of chronic pain conditions.

The Department will sponsor approximately 50 PCMPs to serve as telehealth pioneers for Colorado. Participation in ECHO-like program is easy and the benefits for providers and their clients are significant: click here to view a flier for more information. To learn more & sign-up for the Pain Management Program please e-mail jd.belshe@state.co.us by January 15th.” [Source: HCPF]

Increasing Access to Diabetes Self-Management Education

“Diabetes self-management education/training (DSME/T) is an evidence-based critical point of care program for people with diabetes that can delay or prevent diabetic complications. The objectives of DSME/T include:

• Support informed decision making
• Promote self-care behaviors
• Initiate problem solving
• Promote active collaboration with the health care team
• Improve clinical outcomes, health status, and quality of life

Data published in the CDC's Morbidity and Mortality Weekly Report indicate that less than 7% of privately insured adults with newly diagnosed diabetes from 2009 to 2012 joined a self-management education and training program. Researchers found that older adults and insulin-treated patients were more likely to join such initiatives.

In Colorado, we are working to increase referral to and utilization of this evidence-based program. To find an American Association of Diabetes Educators (AADE) accredited program, click here. To find an American Diabetes Association (ADA) recognized program click here and select Colorado. DSME/T is a covered benefit under Medicare and private health insurance plans. For more information about DSME/T please contact Kelly McCracken at kelly.mccracken@state.co.us or Becky DiOrio at becky.diorio@state.co.us” [Source: COPrevent]

ACA Implementation News

Click here to view the latest issue of the Department of Health Care Policy and Financing’s ACA Implementation News. [Source: HCPF]

Oral Health Funding Opportunities

“Perinatal and Infant Oral Health Quality Improvement: This funding opportunity announcement (FOA) solicits applications for the Perinatal and Infant Oral Health Quality Improvement (PIOHQI) Expansion Grant Program, the second phase of the Perinatal and Infant Oral Health National Initiative. The goal of this grant program, as with this multi-phase initiative, is to reduce the prevalence of oral disease in both pregnant women and infants through improved access to quality oral health care. By targeting pregnant women and infants most at risk for disease, during times of increased health care access, the expected result is improved oral health and oral health care utilization of the mother and her child throughout their lifespan. Ultimately, by linking the delivery of oral health with primary care, the overall well-being of pregnant women and infants will be improved. For more information about this grant opportunity, visit grants.gov.

ADA Foundation Accepting Oral Health Education Grant Applications: The ADA Foundation (ADAF) is now accepting applications for its Semi-annual Grants with a focus on oral health education. Grants of up to $5,000 will be awarded to nonprofit organizations whose work aligns with the ADA Foundation's mission to improve the oral health of the public through education. The application deadline is Jan. 30, 2015. Visit ADAF's website to review and download the application or see a list of previous grant recipients. Please contact Cathy Haibach at the ADA Foundation, 312-440-2547 or haibachc@ada.org, if you have questions.” [Source: Oral Health Colorado]

ClinicNET Affiliate Staff: Don't forget to compete our annual affiliate survey!

Are you a ClinicNET affiliate? If you have not done so already, please complete our 2014 ClinicNET Affiliate Survey by noon on Monday, January 12th. All respondents will be entered into a drawing to win 1 of 2 $25 Amazon.com gift cards! Your participation will help us understand our impact, your needs and how we can improve our technical assistance, outreach, education & advocacy work.  Thank you in advance for your feedback!

ClinicNET & CORHIO Health Information Exchange Webinar

Are you interested in learning more about Health Information Exchange (HIE)? Join us for a webinar on January 20th from noon-1pm, click here to register! We are co-hosting this webinar with CORHIO, the state-designated entity for HIE working closely with and among communities across Colorado to implement a cost-effective and secure system for sharing clinical information. The CORHIO HIE allows participants to access clinical patient data from 57 hospitals and 3 major labs, regardless of EHR status. Learn more about HIE services that can benefit your clinics and have the opportunity to ask questions of the HIE experts. Contact johanna.gelderman@clinicnet.org with any questions.

Half price offer from ClearTriage for Dr. Barton Schmitt’s telephone triage protocols in electronic format

“ClearTriage is a local company providing Dr. Schmitt’s nationally-used telephone triage protocols in software format to pediatric clinics. These are the same protocols used by Children’s Hospital Colorado’s call center, but specially formatted for daytime use in practices and clinics.

ClearTriage is offering their software at a 50% discount to ClinicNET affiliate clinics. The software provides:

• Faster, standardized documentation in your EHR
• 45 protocols not in the book
• Protocol checklists that truly get used, improving triage safety and consistency
• Easy and fast search
• Works with no installation on your computer or network

ClearTriage is available for a 30-day free trial. Learn more at www.cleartriage.com or contact Dave Schmitt at dave@cleartriage.com or 720-593-1001." [Source: ClearTriage]

Department of Health Care Policy and Financing Updatesz: Medicaid Targeted Rate Increase

Community Provider Rate Increase (Medicaid Targeted Rate Increase): Click here to view the proposals being put forward by the Department for Targeted Rate Increases (TRI) for FY’15-16.   These proposals will be considered along with new proposals put forward by stakeholders and submitted as part of the TRI initiative for FY’15-16.

The Department has also extended the submission period for receipt of stakeholder proposals until 5PM Wednesday, January 7th.  All proposals should be submitted to Medicaid2015@state.co.us and must be received by this deadline for consideration. The Department will review all proposals (both external and internal) and will then send its official targeted rate increase recommendations for $16.5M to the Joint Budget Committee for its consideration.

All documents related to the Targeted Rate Increase initiative can be found on the Department’s website at:  https://www.colorado.gov/pacific/hcpf/provider-implementations (Select Targeted Rate Increases)

Medicaid Eligibility for Couples in a Civil Union: On Dec. 8, 2014, HCPF issued an agency letter clarifying how Medicaid eligibility should be determined for couples in a civil union vs. marriage. Effective Oct. 7, 2014, Colorado recognizes same-sex marriages. Medicaid determinations follow federal law, which has specific provisions that apply only to married couples. Because Colorado does not recognize civil unions as marriages, couples in a civil union are considered to be in separate households when determining Medicaid eligibility. All married couples, including same-sex married couples, should be entered as married for Medicaid eligibility determinations.

Potential CICP Policy Changes: Click here to view a document for potential policy changes and implementation dates.

ACA Implementation News: Click here to view the latest issue of the Department of Health Care Policy and Financing’s ACA Implementation News. [Source: HCPF]

Safety Net Technology Group and Practice Administrator Group Kick-Off Meetings

In an effort to provide our affiliates with more opportunities to learn, share and network, ClinicNET will be coordinating and helping to facilitate various one-time and ongoing convenings and gatherings in 2015. We’ll be kicking off a technology cohort and a practice administrators cohort!

Learn from your peers in the industry, discuss challenges and opportunities! Doctors Care in Littleton has graciously offered to host the inaugural gatherings in January (9th or 23rd). During these first convenings we will meet and greet, determine future topics for discussion and education, discuss scheduling and locations for 2015 gatherings, in addition to touring Doctors Care! Refreshments will be served!

Please determine which of your staff(s) would be appropriate for participation and have them complete the doodle scheduling poll below. We will confirm date and time based on best availability. *Please note new dates/times have been added.

• Technology Group: http://doodle.com/k7s3pvp5mrvt4kkg
• Practice Administrators Group: http://doodle.com/npkhsibmvueyqdfb

Questions? Please contact Brooke Powers at brooke.powers@clinicnet.org or 720-863-7803.

The Colorado Health Foundation Applicant Information Webinar

“The Colorado Health Foundation is hosting an Applicant Information webinar for prospective grant applicants on January 9th 11am-12pm. The webinar gives representatives from nonprofit organizations a chance to learn about the Foundation’s grantmaking program, including specific funding opportunities in Health Care, Health Coverage and Healthy Living.

During the webinar, Foundation staff will provide a concise overview of the application process, including: how to prepare applications; important proposal requirements; and a step-by-step walk-through of the online application process. Staff also will review the Foundation's funding priorities and respond to questions about any part of the process.

This webinar requires advanced registration, so please register now. Please note that participation in the webinar is not a required part of the application process. If you have questions, please contact Beth Clemens, events manager, at bclemens@ColoradoHealth.org or 303.953.3691.” [Source: TCHF]

Connect for Health Colorado Updates

• "Our 2015 enrollments went well over the 100,000 mark on December 15. That was also the day we set a single-day record for enrollments, 12,600. See our metrics report. Curious about your area? Check county-level metrics.
• Holiday scheduling note: Our Customer Service Call Center will be closing at 4 p.m. on Christmas Eve, Wednesday, Dec. 24, and will reopen at 7:00 a.m. on Friday, Dec. 26.
• A reminder: As we’re finding solutions to the technical challenges that have complicated some enrollments, we are also compiling a set of tips that you will find helpful in assisting enrollees.
• "They like us. They really like us." While Americans remain evenly divided in their opinions of the Affordable Care Act, four out of five respondents to a recent Kaiser Family Foundation tracking poll said they favor formation of state health insurance Marketplaces. You have to read pretty deep to get to that question but on your way you will also find support for other individual provisions of the law. The poll.” [Source: Connect for Health Colorado]

Colorado PEAK Updates: Mobile App and Webinars

“CO Peak Outreach Team is holding an Application Walk-Through webinar on January 12th from 1-2pm. Click here to register.

PEAKHealth Mobile App for Medicaid & CHP+ Clients: Launching in late December, the new PEAKHealth mobile app gives Medicaid and Child Health Plan Plus (CHP+) members a simple way to keep their information up to date and access important health information right from their phone. The app is for current Medicaid and CHP+ clients who have a PEAK account. PEAKHealth is not for people who want to apply for benefits. Click here to view a video tour of the PEAKHealth mobile app.” [Source: Colorado PEAK]

Happy Holidays from ClinicNET!

Your work inspires us and at the holidays, we are especially grateful for the quality care you provide to uninsured, underinsured and low income Coloradans.

It is an honor to advocate for your clinics and lend a collective voice to your efforts. We wish you the happiest of holidays and look forward to working with you in 2015!

Sincerely,

ClinicNET Board of Directors & staff

Safety Net Technology Group and Practice Administrator Group Kick-Off Meetings

In an effort to provide our affiliates with more opportunities to learn, share and network, ClinicNET will be coordinating and helping to facilitate various one-time and ongoing convenings and gatherings in 2015. We’ll be kicking off a technology cohort and a practice administrators cohort!

Learn from your peers in the industry, discuss challenges and opportunities! Doctors Care in Littleton has graciously offered to host the inaugural gatherings in January (9th or 23rd). During these first convenings we will meet and greet, determine future topics for discussion and education, discuss scheduling and locations for 2015 gatherings, in addition to touring Doctors Care! Refreshments will be served!

Please determine which of your staff(s) would be appropriate for participation and have them complete the doodle scheduling poll below. We will confirm date and time based on best availability. *Please note new dates/times have been added.

• Technology Group: http://doodle.com/k7s3pvp5mrvt4kkg
• Practice Administrators Group: http://doodle.com/npkhsibmvueyqdfb

Questions? Please contact Brooke Powers at brooke.powers@clinicnet.org or 720-863-7803.

New Funding Opportunity from the Colorado Health Foundation: Team-Based Care

“The Colorado Health Foundation is excited to announce the opening of a new funding opportunity within our Health Care outcome area.

Funding Opportunity: Team-Based Care
The Foundation is dedicated to improving Colorado's primary care through a new funding opportunity focused on optimizing existing care teams to deliver coordinated, high-quality care. The three-and-a-half year opportunity will build off the Foundation's previous investments in practice transformation and integrated care and help prepare primary care practices throughout the state to capitalize on future delivery and payment reform opportunities.

In an attempt to benefit underserved populations and have a greater impact on the primary care system across the state, any primary care clinic (non-profit and for-profit) that serves a significant population of underserved patients is welcome to submit a letter of intent (LOI) by February 15, 2015.

Specifically, we are interested in providing technical assistance to up to 30 clinics to assemble a work plan and budget to strengthen the delivery of their team-based care. Participating clinics will be eligible to apply for three-year grants or no-interest loans to implement their work plans in June 2015. To be considered for funding, applicants must meet specific criteria.

Get more information about this funding opportunity by downloading the FAQ and attending an informational webinar on Jan. 14, or by contacting the program officer for this funding opportunity, Tanya Weinberg at 303-953-3643 or tweinberg@coloradohealth.org.” [Source: The Colorado Health Foundation]

Colorado awarded SIM Funding!

“The Centers for Medicare and Medicaid Innovation (CMMI) has awarded Colorado with $65 million in State Innovation Model (SIM) funding to create a coordinated, accountable system of care that gives Coloradans access to integrated primary care and behavioral health. Click here to view the press release for the announcement.

Workgroup progress:
HIT, Data and Quality Measures: The group gained consensus on the following two pediatric measures to be included in SIM: (1) Postpartum depression screening, and (2) Developmental screening. The group has been evaluating these measures from a data and cost perspective. A review of public health data integration will occur as a next phase of work, and a meeting with the Local Public Health Agencies is planned early in 2015. A follow-up meeting of the HIT, Data & Quality Measures group is also planned before the end of the year.

Payers, Purchasers and Payment Reform: The group had a successful kick-off in November and is currently working on a schedule for regular meetings in the new year.

Population Health and Consumer Engagement: Joe Sammen from CCMU will be replacing Gretchen Hammer as co-lead with Dr. Larry Wolk, with Gretchen Hammer's transition to the Colorado Department of Health Care Policy and Finance. A meeting is being scheduled for January, 2015.

Service Delivery and Practice Transformation: Currently, the group is focusing on the development of practice milestones. It has reviewed the Comprehensive Primary Care initiative milestones, which will serve as a foundation of SIM milestones development, as well as looked at other relevant resources (i.e. Transforming Clinical Practices Initiative). Over the next month, the group will be facilitating targeted discussions around the milestones, including: pediatric-specific considerations and integrating primary care into a CMHC setting.

The SIM Team would like to extend its gratitude to those who submitted a post-meeting evaluation survey for the SIM conference on 11/20. We appreciate the valuable feedback we received from you. Please use the following link to download a PowerPoint presentation that illustrates the results of the survey: Click here to download the PowerPoint.”  [Source: Colorado SIM]

RCCO Contracts Extended for 1 Year

“The Department has received approval to extend the current RCCO contracts for one year. The current RCCO contract period will now end June 2017.  A Request for Proposals will be released in the summer of 2016. This timeline change is necessary for the following reasons:

• The new MMIS and its associated data and analytics systems will be implemented prior to 2017;
• More time to assess lessons learned in the current  RCCO contracts and the 1281 Payment Reform Program  and incorporate those lessons into the next program design;
• Federal innovation opportunities such as the State Innovation Model and the Innovation Accelerator Program may be better poised to be leveraged in 2017;
• Significant change will likely require a federal waiver.

The timeline to develop the next iteration of the ACC remains very tight.   Even with an additional year before RFP publication, the Department intends to have the majority of programmatic details defined by spring 2015. Please don't hesitate to contact us at RCCORFP@state.co.us with questions and concerns.” [Source: HCPF]

Department of Health Care Policy and Financing Updates - Medicaid billing & ACA Implementation News

Click here to view a document outlining the Department’s established policy and State statute regarding billing of Medicaid members. This policy applies to both Medicaid and non-Medicaid enrolled providers.

Click here to view the latest issue of HCPF’s ACA Implementation News. [Source: HCPF]

Cavity Free at Three hosts training

“Medical providers, dental providers, clinical staff and children’s health advocates are invited to a free training on Thursday January 29th, 9am-12:30pm to learn how to:

• Incorporate children's preventive oral health services into your practice
• Prevent dental disease
• Assess caries risk
• Deliver anticipatory guidance and patient education
• Provide oral health evaluations

Medical providers will receive certification needed to bill Medicaid and CHP+ for oral health services. Please RSVP by Jan. 15, 2015. Training will be held at CDPHE | 4300 Cherry Creek Drive South | Denver, CO 80246.” [Source: COPrevent]

Colorado Children’s Healthcare Access Program Updates

“Beginning January 1, 2015, the Colorado Medical Assistance Program (Medicaid) will reimburse covered office visit procedure codes (E&M codes) and the vaccine administration procedure codes for all providers at a rate equal to 100% of Medicare’s December 2014 reimbursement rate. The new rate will be available to all enrolled providers that submit fee schedule claims for office visits or vaccine administrations. The new reimbursement rate will be in place until June 2016.

Check out CCHAP’s latest Practice Manager Newsletter for more information on:

• Flu Vaccine Administration Code Additions
• Influenza Vaccine Coding and Rate Table
• Depression Screening and Important Coding Changes
• Community Provider Rate Increase
• Cavity Free at Three
• New State Medicaid Director
• Locum Tenens

Also available is CCHAP's latest Clinical Newsletter.” [Source: CCHAP]

Articles & Publications and new resources

Underinsurance Remains Big Problem Under Obama Health Law
The New York Times – December 1, 2014

State of the Safety Net 2014
November 2014 – Direct Relief

Colorado’s Progress Toward a Simplified Medicaid and CHP+ Enrollment System: 2014 Update
Colorado Covering Kids and Families – November 2014

We’ve also added new resources to our website, including:

• Agency for Healthcare Research and Quality

Visit the ClinicNET website for more Articles and Publications and Resources.

Interested in being part of a safety net clinic practice administrators group?

In an effort to provide our affiliates with more opportunities to learn, share and network, ClinicNET will be coordinating and helping to facilitate various one-time and ongoing convenings and gatherings in 2015. We've already sent out information on a safety net clinic technology cohort, and we are also hoping to kick-off a Practice Administrators group!

Learn from your peers in the industry, discuss challenges and opportunities! Doctors Care in Littleton has graciously offered to host the inaugural gathering in January (9th or 16th.). During this inaugural informal gathering we will meet and greet, determine future topics for discussion and education, discuss scheduling and locations for 2015 gatherings, in addition to touring Doctors Care! Refreshments will be served!

Please determine which of your staff(s) would be appropriate for participation and have them complete this doodle scheduling poll: http://doodle.com/npkhsibmvueyqdfb We will confirm date and time based on best availability.

Questions? Please contact Brooke Powers at brooke.powers@clinicnet.org or 720-863-7803.

ACC: MMP materials, Accountable Care Collaborative: Medicare-Medicaid Program

“We are 4 months into the implementation of the statewide Accountable Care Collaborative: Medicare-Medicaid Program (ACC: MMP) and we wanted to remind you of all the resources we have created to help clients, providers, advocates, etc. better understand the program. Check out our new website for all the resources:

• ACC: MMP - Program Information, webinars, and trainings (Click and expand the “Accountable Care Collaborative (ACC): Medicare-Medicaid Program training and…” box)
• ACC: MMP - Information for Clients
• ACC: MMP – Advisory Subcommittee Page
• ACC: MMP – Stakeholder meeting information

General Program Description:
Colorado is one of 15 states participating in a Centers for Medicare and Medicaid Services (CMS) demonstration to test models of financial alignment between the Medicare and Medicaid programs. The goal of the demonstration is to improve health outcomes and client experience while reducing costs and unnecessary services for full-benefit Medicare-Medicaid enrollees. To implement this program, Colorado will enroll Medicare-Medicaid client’s into the Accountable Care Collaborative (ACC) program, which is Colorado’s primary healthcare delivery system.

The Accountable Care Collaborative: Medicare-Medicaid Program (ACC: MMP) is a program for people eligible for both Medicare and Medicaid. It gives members their full benefits and the freedom to choose their own doctor while emphasizing coordinated care and good health outcomes. A Primary Care Medical Provider (PCMP) serves as a medical home that leads the member’s health care team, connecting members to health care and tracking their progress and outcomes.

ACC members and their PCMPs belong to a Regional Care Collaborative Organization (RCCO). The RCCO has a network of both medical and non-medical service providers to help ACC members get what they need to be healthy. RCCOs also work with PCMPs to coordinate the care of ACC: MMP members with complex health needs. Care coordinators help members find the right health care, learn self-care, and find non-medical services like housing, food and fuel assistance. There are seven RCCOs in the state.

The RCCO helps providers, too. RCCOs make it easier for providers to navigate the Medicaid and Medicare systems, and improve their practices so providers can focus on delivering care. The RCCO also tracks trends in health services and health outcomes, so PCMPs can be rewarded for good outcomes and not just for delivering services.” [Source: HCPF]

ClinicNET Conversations: December blog post by ClinicNET ED, Sharon Adams

Check out Sharon’s December blog post, “Gratefulness... When Less Means More.”

“In February of this year in my first ClinicNET Conversations blog, I expressed my wish that I could predict what the future would hold for Community Safety Net Clinics (CSNCs) and for the state of health care in Colorado. With 2014 coming to a close, the future still isn’t exactly crystal clear, but I can say we’ve made significant progress as we prepare for 2015.” Continue reading…

Kaiser Loan Repayment Program Kick Off Call & Webinar

"We would like to invite you to the kick off call for the Kaiser Permanente Loan Repayment for Safety Net Clinical Support Staff (KPRLP) program on Thursday, Dec. 18th from 12:30 – 1:30 p.m. The Colorado Community Health Network was funded by Kaiser Permanente Community Health Fund to administer a loan repayment program for clinical support professionals at ClinicNET affiliate clinics, Rural Health Clinics, and Community Health Centers. Click here for more information on eligibility.

This kick off call will provide information for human resources staff and program managers at safety net clinics that will be helpful for supporting your staff as they apply for the KPRLP. Topics covered will include an overview of the program and application process, program requirements and eligibility, the role of HR staff/program managers, and helpful tips for marketing the program to your staff and supporting applicants through the process. CCHN staff will be also be available to answer questions about the program during this call.

Call in and webinar information is below:
Call: 866-740-1260; Access code: 4267364
Webinar Log-in: www.readytalk.com; Access code: 4267364" [Source: CCHN]

Henry Schein Dental Group Purchasing Opportunity

Non-profit ClinicNET affiliate clinics are eligible to participate in the Henry Schein Dental Group Purchasing agreement administered by the Colorado Community Health Network. Under the Henry Schein Dental agreement, there are 4,000 items specially discounted for clinics participating in the GPO. Discounts for items not on that list include:

• 21% off Dental Merchandise
• 15% off Films, Amalgams, Anesthetic
• 10% off small equipment and hand pieces

If you are interested in learning more or signing up, please contact Katlyn Leight at kleight@cchn.org or 303-861-5165. [Source: CCHN]

Pfizer Healthcare Charitable Contributions Program

“The Pfizer Healthcare Charitable Contributions Program supports nonprofit organizations that offer healthcare related programs and activities for patients. The specific grantmaking areas of interest are: 1) patient education, including health screening; 2) patient advocacy for disease awareness; and 3) improving patient access to care, including transportation costs. Requests are reviewed quarterly. The upcoming funding cycle will be open from December 1, 2014, through January 15, 2015. Visit the Pfizer website for more information. “ [Source: NAFC]

Proposed HHS Notice of Benefit and Payment Parameter, CoveredU.org, & Full Exposure Campaign

“Proposed HHS Notice of Benefit and Payment Parameter for 2016: The Department of Health and Human Services recently published a new proposed rule that will, if adopted in its current form, establish important 2016 Marketplace standards to improve consumers’ experience and affordable coverage.  The rule covers a large array of issues. Public comments must be received before 5:00pm on December 22, 2014. For more information on the proposed regulation read the Proposed HHS Notice of Benefit and Payment Parameter for 2016 Fact Sheet and Implementing Health Reform: 2016 Benefit And Payment Parameters Proposed Rule, Consumer Provisions; Hardship Exemptions.

The Colorado Consumer Heath Initiative (CCHI) created a new website to direct users to either “How to USE your health insurance” or “How to SHOP for health insurance.” CoveredU.org is a great resource to get people started on understanding how to use their insurance through interactive scenarios where they can see how their health care decisions could play out. The Spanish version of CoveredU should be available next week at SeguroTU.org.

Taking lessons from current websites and campaigns like “Humans of New York”, CCHI’s new Full Exposure campaign tells the story of everyday Coloradans who are benefiting from health reform and are thankful for their coverage. This campaign will run on Facebook, Twitter and CCHI’s website through the end of open enrollment, February 15, 2015. Join us in sharing success stories to encourage others and increase enrollment in Connect for Health Colorado health insurance plans. If you'd like to share your story for this campaign, please click here or contact Lynn Doan.” [Source: CCHI]

HIE’s Expanding Role in Population Health Management Webinar

"Join Morgan Honea, CEO of CORHIO, and Jason Greer, Executive Director of CCMCN, for this informative webinar on how Health Information Exchanges give providers instant access to critical healthcare information from across the healthcare continuum, allowing them to better coordinate care and make informed decisions that are in the best interest of each patient. This webinar will provide an overview of population health management and examine the ways in which HIEs are strengthening care coordination efforts.

The webinar is December 18, 11am-12pm. The webinar is free, but registration is required, please visit the website for details and to register." [Source: CORHIO]

Connect for Health Colorado Updates

• “The rate of enrollments is increasing as we move toward the Dec. 15 deadline. With our state Health Care Policy and Financing partners, we reported earlier this week that 22,487 Coloradans enrolled in health care coverage for 2015 between Nov. 15 and Nov. 30. That includes Medicaid, Child Health Plan Plus (CHP+) and private health insurance purchased through the state health insurance Marketplace. You can read the news release here.
• We are aware some of our customers are encountering problems completing the application for financial assistance. We are working with these folks to ensure they get January coverage. You can read our message to customers.
• OK, we admit it. Health insurance isn’t always fun. However, the state Division of Insurance managed to find a fun way to help people understand what can increase the cost. It’s an animated video, a story telling format we never tire of sharing. Check it out here.
• We recently met with members of the Colorado State Auditor's Office to discuss a list of recommendations for how Connect for Health Colorado's policies and processes can be improved to better serve our customers and our state. If you have questions, or would simply like an opportunity to give us your thoughts and input, please don't hesitate to reach out to our team at outreach@connectforhealthco.com.” [Source: Connect for Health Colorado]

The Colorado Trust Funding Opportunity – Health Equity Learning Series 2015

“The Colorado Trust is pleased to announce another funding opportunity to increase awareness and understanding of health equity. We are continuing the Health Equity Learning Series through 2015 and will host national experts for events in Denver on the following dates: Feb. 5, 2015; May 14, 2015*; July 23, 2015*; and Sept. 17, 2015*. *Dates are tentative and may change. Speakers will be announced in early 2015.

We would like to partner with organizations across the state to live-stream the events in their communities, followed by discussion and networking. Through a Request for Applications process, we would like to encourage nonprofit organizations and groups to apply to host the four events, with Colorado Trust grants supporting associated costs such as facility rentals, audio/visual technical support, event marketing, food and other event costs. Please note that applications are due to The Colorado Trust by 5 p.m. MST on Dec. 19, 2014.

For more information about this Request for Applications, please contact Maggie Frasure, Communications Manager at The Colorado Trust at maggie@coloradotrust.org.” [Source: The Colorado Trust]

Senior Dental Advisory Committee Update – revised grant program rules

“Click here to view the draft of the Senior Dental Grant program rules. For those interested in attending there will be a rule review meeting on December 22nd and then the Medical Services Board will meet on January 9th. More information on the rule review meeting and the Medical Services Board can be found on our website. If you have any additional questions, comments, or feedback please contact Nancy Dolson at Nancy.Dolson@state.co.us.” [Source: HCPF]

5-week Spanish Parent Class

“Families First invites parents to participate in a 5-Week Class. Parenting children can be difficult. Many of the discipline methods that parents have used in the past are no longer working as effectively causing frustration and a breakdown in behavior and communication. This workshop will provide parents with understanding, practical tools, hope & encouragement in their role as a parent. Click here for more information.

Classes begin January 14th and are held every Wednesday for 5 weeks from 10-11:00am at 13645 E. Bayaud Avenue | Aurora CO 80012. Cost is $25 for all sessions.” [Source: Families First]

Interested in being part of a safety net clinic technology group?

In an effort to provide our affiliates with more opportunities to learn, share and network, ClinicNET will be coordinating and helping to facilitate various one-time and ongoing convenings and gatherings in 2015.

Please consider joining us as we kick-off a technology cohort! Learn from peers in the industry, share how your clinic is utilizing technology, discuss challenges and talk about future plans! Doctors Care in Littleton has graciously offered to host the inaugural gathering in January (9th or 16th.). During this inaugural informal gathering we will meet and greet, determine future topics for discussion and education, discuss scheduling and locations for 2015 gatherings, in addition to touring Doctors Care! Refreshments will be served!

Please determine which of your staff(s) would be appropriate for participation and have them complete this doodle scheduling poll: http://doodle.com/k7s3pvp5mrvt4kkg We will confirm date and time based on best availability.

Questions? Please contact Brooke Powers at brooke.powers@clinicnet.org or 720-863-7803.    

2015 Legislative Forecast: What to Expect When You're Expecting Gridlock

“Winds of change are blowing at the Colorado Legislature. With Republicans now in control of the Senate and Democrats retaining the House majority, it seems like a formula for gridlock. But could it be an opportunity to cooperate? Join the Colorado Health Institute for a webinar to hear our predictions for the 2015 session, where we'll talk about windmill jousting, Hobby Lobby and, of course, all the latest in health policy.

Click here to register for the “2015 Legislative Forecast: What to Expect When You're Expecting Gridlock” webinar on Wednesday, December 10, 12-1pm. Space is limited.” [Source: Colorado Health Institute]

Community Meeting regarding Recent Changes to Denver Health Managed Care Medicaid

Community Meeting regarding Recent Changes to Denver Health Managed Care Medicaid
Friday 12/12/14, 11:00 am at 1532 Galena Street, Aurora, CO 80010, Room 395
Hosted by P.J. Parmar, MD, Ardas Family Medicine

In response to concerns from Medicaid providers and patients, there have been some major recent changes to Denver Health Medicaid Choice (DHMC) which will benefit Colorado Medicaid patients. Now ANY primary care provider can be paid to see ANY DHMC patient (who they have a relationship with) at ANY time. In addition, ANY DHMC patient can be dis-enrolled from DHMC (changed to regular Medicaid), at ANY time (not just during certain months). Also, non-Denver Health providers can get paid for DHMC patients they previously saw for free, billing back to the start of 2014 (must be done by end of 2014). The Department of Health Care Policy and Financing (HCPF), the state entity overseeing Medicaid, has verbalized a commitment to eliminating the current passive enrollment process of Medicaid clients into DHMC, and these recent DHMC changes are to improve access to care until then. This meeting is so that patients and providers can better understand these recent major changes, can learn how to navigate the dis-enrollment, authorizations, and billing, and can express concerns remaining after these changes. Representatives from DHMC and HCPF will be present. This meeting is open to all, but office managers and providers may find particular use. RSVP for lunch to welcome@ardasclinic.com.

Department of Health Care Policy and Financing Updates

January 2015 Changes to 5% Disregard: Beginning January 1, 2015, the Department will implement changes to the manner in which the 5% income disregard is applied to individuals applying for Medicaid and CHP+.

The 5% income disregard will be applied when countable income exceeds the limit for MAGI populations under Medicaid or CHP+. The 5% income disregard will not be applied to every MAGI eligibility determination; it will be applied as a last step in determining eligibility when an individual exceeds the income limit, but is within the income standard if the 5% disregard were applied.

For more information on this change taking effect January 1, 2015, please see the FAQs on Colorado.gov/HCPF/ACAResources > Fact Sheets & Frequently Asked Questions.

Payment for Office Visits and Vaccine Administration Increased Rates: Beginning January 1, 2015, the Colorado Medical Assistance Program (Medicaid) will reimburse covered office visit procedure codes (E&M codes) and the vaccine administration procedure codes for all providers at a rate equal to 100% of Medicare’s December 2014 reimbursement rate. The new rate will be available to all enrolled providers that submit fee schedule claims for office visits or vaccine administrations. The new reimbursement rate will be in place until June 2016.

Please note that this rate increase is not a continuation of the previous 1202 Primary Care Supplemental quarterly payments.  This increase does not require providers to attest to providing primary care and the higher rate is paid for each claim submitted.  Please also note that Medicaid will not be changing its reimbursement for E&M codes on a quarterly basis, as Medicare does.  E&M codes will be paid at the December 2014 Medicare rate, regardless of whether Medicare raises or lowers its reimbursement of these codes over the coming months.

Click here to view the Department’s response to the Join Budget Committee’s Request for Information #4 regarding the Accountable Care Collaborative.

View the November 26 and December 4  issues of HCPF’s ACA Implementation News.

Click here to view the November edition of At A Glance. [Source: HCPF]

Community Provider Rate Increase (Medicaid Targeted Rate Increase) – Input Requested

“As you may be aware, as part of our FY2015-16 budget the Department requested a 0.5% provider rate increase that will apply to all eligible providers effective July 1, 2015, pending approval by the General Assembly. As part of that same request, the Department has requested an additional $16.5M to address large inequities in rates and to focus on paying for services that provide high value and better access for our clients.

We would like to have your input about how and which providers and services should be considered to receive part of that $16.5M targeted rate increase. We need your responses by 5:00pm on Friday, January 2, 2015. It’s a busy month, so please mark your calendars to make sure your voice is heard.

While we recognize that across-the-board rate increases are important to our providers, they continue to incentivize volume over value—a trend we are trying to reverse. An increase of 0.5% is not a total solution, but it is another step towards paying for better value for our clients and improving access to care. If we spread out the 0.5% increase across-the-board to all providers, the impact per provider would be very small.

That’s why we are asking for your recommendations to help decide which services and specialties are most in need of rate adjustments. We want to ensure we are using our limited resources to accomplish two things: address serious inequities in rates, where they exist, and promote high quality, cost effective procedures that improve client outcomes and reduce expenditures for the State.

Click here to view document outlining the process for submitting your response and the criteria for evaluating the responses submitted. Please submit all responses and questions to: Medicaid2015@state.co.us. Within the next ten business days, we will also send you a framework of potential recommendations from the Department based on feedback received from you and other stakeholders over the past year. Your input will help us evaluate this initial set of recommendations, as well as identify additional ones. We will post these documents and any further notifications on our website at https://www.colorado.gov/pacific/hcpf/provider-implementations (Select “Targeted Rate Increase”).” [Source: HCPF]

Invite to Regional Extension for Community Health Outcomes (ECHO) Meetings

“You are invited to learn more and provide input about developing a Colorado ECHO:  Extension for Community Health Outcomes, based on the peer-learning method developed by the University of New Mexico School of Medicine.  This method uses bi-directional video technology to support case-based, peer learning networks to build capacity to better manage diseases.  CO ECHO emphasizes the dissemination of evidence-based knowledge and guidelines and emerging best-practices across the health care and public health workforce.   A series of “virtual” regional meetings will be held in December to share the vision and to continue to get feedback to help shape the final vision of CO ECHO.   Virtual meetings will use “Zoom.”  You will simply need a computer with a camera or a phone to join the meeting.  Click here to view a flier with links to the registration for this event.” [Source: HCPF]

Denver Health Medicaid Choice (DHMC) process changes

Click here to view more information on the Denver Health Medicaid Choice (DHMC) process regarding disenrollment request, authorization request and claims submission related to passive enrollment. Below are highlights from the letter, please be sure to read the full letter carefully.

• Disenrollment process: Any non-DH provider that has an existing relationship with a member who has been passively enrolled into DHMC can assist the member to contact HealthColorado either by phone or by faxing form to request disenrollment (fax # 303-832-8352).
• Process for providers to obtain authorization from DHMC regarding passively enrolled members: Providers must submit (via fax 303-602-2128) an “Outpatient Provider Referral Form.pdf” to the Denver Health Managed Care Utilization Management (UM) department.
• Process for providers to obtain claims reimbursement from DHMC regarding retrospective claims for passive enrollees:  DH MCD Choice shall reimburse any non-DH provider rendering primary care services to a passively enrolled member for dates of services 120 days prior to the date of disenrollment from DH MCD Choice. All retrospective claims must be submitted via fax (preferred method) at 303-602-2096 to DHMC by December 31, 2014.