Denver Health Medicaid Choice (DHMC) Passive Enrollment Modification

“The Department of Health Care Policy and Financing (HCPF) in conjunction with Denver Health Medicaid Choice (DHMC) is modifying the DHMC passive enrollment process. The current DHMC passive enrollment process enrolls ALL Medicaid eligible Denver County residents into DHMC regardless of current plan or previous history with a non-Denver Health provider. This process has negatively affected some Medicaid population’s ability to receive services. DHMC and HCPF have collaborated and created a new process intended to decrease the roadblocks for those negatively affected.

During the month of May, the current MMIS DHMC passive enrollment logic will be removed and a new process will be implemented that prevents DHMC passive enrollment of the following:

• Medicaid clients with existing attribution to a non-DHMC provider.
• Refugee populations that utilize Volunteer Agencies addresses as residential addresses
• Foster children

Removing these populations from the DHMC passive enrollment process does not restrict the client from selecting DHMC as a health plan; it merely provides the client with ability to choose their plan and not be defaulted into DHMC. The modified process will be implemented beginning June 1, 2015 and will be seamless to the client and health plans.

This new process will only be applicable to newly eligible Medicaid clients and will not affect currently enrolled clients. All other existing process and procedures related to enrollment are unchanged (e.g. open enrollment, etc.). If you have any questions or concerns please contact the Denver Health Contract Manager, Jeremy Sax at jeremy.sax@state.co.us or 303-866-3227.” [Source: HCPF]