What's next at the national level with health care?

Its been one week since the American Health Care Act (AHCA) was pulled off the House floor for lack of votes! Some thoughts shared by the Colorado Health Policy Coalition:

"If you are interested in a blow by blow of the decision to pull the legislation, the New York Times has a comprehensive overview. The Washington Post published a particular take on key learnings from the failure of the American Health Care Act and realities for the Affordable Care Act going forward. Also of interest is this piece highlighting the very different individual stories of impact from Colorado ahead of the legislation’s collapse last week. In regard to our federal delegation, while no House members ultimately cast a final vote on the American Health Care Act, only one Colorado delegation member – Rep. Mike Coffman – voiced support for the measure throughout the debate.

Finally, it’s worth noting that as the nation waits for any next steps from Congress, there are executive branch actions that can be launched to begin the process of unwinding the Affordable Care Act. Through two actions taken on the first day of his presidency as well as other prerogatives, President Trump and his administration have avenues to begin to reshape the existing health care framework should they choose to pursue those. These include:

1.     Regulatory Moratorium: Traditionally enacted by incoming presidents, the moratorium stops rulemaking from the previous administration including postponing rules that had been published but had not taken effect. This act halted regulatory action ranging across agencies and includes things like Health and Human Services poverty guidelines. Additional direction by the Trump Administration includes directives that two existing regulations must be eliminated whenever a new regulation is proposed as well as the directive that each agency install a Regulatory Reform officer charged with ensuring their agency is expediting regulatory reform.

2.     Executive Order on the Affordable Care Act: Signed on inauguration day, the order grants agencies broad latitude to begin unwinding the Affordable Care Act within existing law. Agencies particularly empowered by the executive order include the Department of Health and Human Services, the Internal Revenue Service and the Department of Labor.

Potential areas of action could include:

·         Relaxation of Essential Health Benefits

·         Reexamination of some Preventative Services, particularly in women’s health

·         Cost-sharing reductions

·         Loosening of criteria for grandfathered plans to allow more to continue

·         Issuing of new guidance on eligibility and enrollment

·         Changing support for and policy for federally facilitated marketplaces

·         Supporting congressional efforts to change the ACA already in motion including by withholding risk-corridor payments and challenging in court federal responsibility for cost-sharing reductions. The Trump administration could stop defending the law in that case. If Congress wins the case, health plans, not the federal government will be responsible for making those payments." 

We don't know what will happen next so I encourage you to continue to engage via the Protect our Care Colorado Campaign! 

• http://www.politico.com/story/2017/03/trump-obamacare-explode-236623
• http://www.npr.org/sections/health-shots/2017/03/29/521713002/6-changes-the-trump-administration-can-still-make-to-obamacare

Coalition for Immigrant Health

Coalition for Immigrant Health, formed in 2016, is a growing group of organizations who have come together based on the commonly held principle that immigrants of any status (which also include refugees and asylees) contribute in meaningful ways to Colorado, and therefore, should have equitable access to needed health care and coverage. Organizations work together in this Coalition to defend Colorado’s immigrant populations against threats to their safety and health, and we also proactively work toward a long-term plan to address the gaps that remain for their health. Interested in being part of Coalition for Immigrant Health? Contact: Aubrey Hill at 504.615.3085 or Aubrey.hill@ccmu.org. (The Coalition is also gathering stories from patients & providers! Click here for Spanish.)

State Legislative Sessions continues!

Thanks to a contract with Frontline Public Affairs, community safety net clinic directors are receiving periodic email updates on the activities in the current 2017 State of Colorado Legislative Session. Click here to view a 2017 bill tracker specifically for community safety net clinics.

Recent revenue projections are not making the state budgeting process any easier as they struggle to balance a budget with a $700 million deficit. Click here to read the Colorado Primary Care Alliance's response to the proposed hospital cuts and the impact on primary care.

In an effort to alleviate some of the state budget woes especially relative to rural Colorado, SB17-267 was introduced as a bipartisan compromise bill and if passed will have significant implications on the state budget. Click here to read more about our state budgeting process, including more information on SB17-267, from the Colorado Health Institute.

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

• Click here for the Senior Dental News Bulletin.

• Request from HCPF: "Last spring, individuals throughout the state, including many of you, took a survey to share your feedback about how to improve the language, look, and feel of eligibility-related client correspondence generated through the Colorado Benefits Management System (CBMS). Using that feedback, earlier this month, we implemented changes to the Income Eligibility Verification System (IEVS) letter and the Medical Assistance Redetermination (RRR) Packets.
  
  Now, the Departments of Health Care Policy & Financing and Human Services, Connect for Health Colorado and the Governor’s Office of Information Technology are tackling the Notice of Action (NOA), and we need your help once again. Drawing on your feedback from last spring combined with two rounds of client interviews around the state, we have developed an updated draft NOA, but we’re not done yet.
  
  We want to hear from you again. Once again we have engaged Joining Vision and Action (JVA) to create and analyze a survey to gather your feedback on this updated draft NOA. This brief and anonymous survey will take approximately 10 minutes to complete. We will use the data from the survey responses to improve the language and format of the NOA.
  
  The survey can be accessed by clicking the following link: https://www.surveymonkey.com/r/RevisedNOAFeedback2017 The survey closes on Friday, April 7 at 5 p.m. Please complete the survey and share the link with your colleagues."

Community Safety Net Clinics reconvene April 26, 1-4pm

Thank you to those clinics that participated in the facilitated strategy session on Monday! You heard updates on outreach with health funders, community stakeholders and partners from Kraig Burleson (Inner City Health Center), Jessica Dunbar (Rocky Mtn Youth Clinics) & Kim Boyd (ClinicNET's last Board Chair). We will reconvene on April 26, 1-4 pm. More info to come! Stay tuned!

American Health Care Act (AHCA) pulled from the House floor!

The American Health Care Act (AHCA) was just pulled from the House floor by the Republicans! They did not have the votes to pass it!

Vox - Paul Ryan just canceled the House health bill vote in a major defeat for President Trump

State legislative session continues!

Thanks to a contract with Frontline Public Affairs, community safety net clinic directors are receiving periodic email updates on the activities in the current 2017 State of Colorado Legislative Session. Click here to view a 2017 bill tracker specifically for community safety net clinics.

Part of the legislature's work includes the 2017/2018 State Budget (aka 'the long bill'). The Joint Budget Committee finalized the budget yesterday so the long bill will be introduced on Monday. Click here to read Frontline's Long Bill Summary.

Final reminder! PLEASE PRIORITIZE THIS ENGAGEMENT…your voice is essential!

Clinic directors: Please attend a facilitated strategy session this coming Monday, March 20, 1:00-4:00pm at COPIC, Stapleton Rm (7351 E. Lowry Blvd., Denver) to hear updates on outreach with health funders, community stakeholders and partners from Kraig Burleson, Jessica Dunbar & Kim Boyd (ClinicNET's last Board Chair). NOW is the time to reconvene and chart the plan for next steps for a collective voice for community safety net clinics! If you have not done so already please reply to this email with your RSVP.

If you are not able to attend in person please join us virtually via Zoom:

• Join from PC, Mac, Linux, iOS or Android: https://zoom.us/j/337894111
• Or iPhone one-tap (US Toll):  +16465588656,337894111# or +14086380968,337894111#
• Or Telephone: Dial: +1 646 558 8656 (US Toll) or +1 408 638 0968 (US Toll), Meeting ID: 337 894 111

What's happening on the national level with health care? Plenty!

Despite the release of the scoring and coverage impact analysis from the Congressional Budget Office (CBO), the American Health Care Act (AHCA) is moving through Congress!

• Click here to read the Colorado Center on Law and Policy's (CCLP) analysis of the CBO score for Colorado.
• Click here to read the Colorado Health Institute's latest analysis of the AHCA relative to Medicaid.

Interested in letting Colorado's Congressional delegation know your concerns? The Protect Our Care Colorado campaign has plenty of information on how to do so including signing on in opposition to the American Health Care Act and the Protect Our Care Colorado letters to members of Congress. (Sign on by March 20th)

State legislative session continues!

Thanks to a contract with Frontline Public Affairs, community safety net clinic directors are receiving periodic email updates on the activities in the current 2017 State of Colorado Legislative Session. Click here to view a 2017 bill tracker specifically for community safety net clinics.

Part of the legislature's work includes the 17/18 State Budget (aka 'the long bill'). Click here for a report from Frontline on the recent Joint Budget Committee (JBC) figure setting hearing for the Dept. of Health Care Policy & Financing (HCPF). "The biggest news was their decision to draft a potential JBC bill to authorize the Medicaid Accountable Care Collaborative (ACC) Phase II and Medicaid’s proposed payment reform projects." Learn more about Medicaid's payment reform work: alternative payment models for primary care and the ACC 2.0: https://www.colorado.gov/pacific/hcpf/accphase2

Latest from CO Dept. of Health Care and Financing (HCPF)

• Click here to read the latest State Innovation Model (SIM) newsletter.

Response from Provider Relations staff at HCPF regarding the many challenges being experienced due to the new claims payment system, the Colorado interChange, for processing payments for Health First Colorado (Medicaid) and Child Health Plan Plus (CHP+):

"We are still working to resolve the issue of long wait times and dropped calls at the HPE Call Center.  HPE is hiring new agents and training them as quickly as possible, but a newly minted Call Center Rep won’t have the depth and breadth of experience that more seasoned reps will have in time. We are grateful that many of our reps have previous experience with Xerox and are able to “translate” provider concerns more easily.

We are also being impacted by a high number of provider calls that could have been resolved by using our online resources, which we update on a daily basis.  Please be sure that your colleagues are aware of our online resource page: https://www.colorado.gov/hcpf/provider-resources.  This is where we post updates on known issues and potential workarounds or resolutions, as well as Cheat Sheets and FAQs that are being developed based on provider feedback. We also encourage all providers to take all the relevant Webinar trainings, read the updated provider manuals, etc. so that they are current on important changes in the new system.

Our EDI Support page at https://www.colorado.gov/hcpf/edi-support and the updated Companion Guides for batch billers and clearinghouses is also a great resource.  

We are concerned to hear about patient prescription issues, as those need to be resolved immediately for our members. Are the safety net clinics getting the support they need from Magellan to resolve those issues?  If not, please send me the pertinent data and I’ll get the issue escalated internally.

Finally, we have established a tracking form to report issues we hear about from our providers.  This list of issues is reviewed and triaged daily so that we can address systems issues as they are reported and assist providers who are in critical need of support in order to meet payroll, etc.  HPE is performing systems changes every evening starting around 7pm, often running until midnight.  We hope that these changes will soon help providers move through the system more easily."

WE STILL NEED YOUR VOICE IN ALIGNING FUTURE WORK ON BEHALF OF COMMUNITY SAFETY NET CLINICS (CSNCs)!

Clinic directors: Please attend a facilitated strategy session on Monday, March 20, 1:00-4:00pm at COPIC (7351 E. Lowry Blvd., Denver) to hear updates on outreach with health funders, community stakeholders and partners from Kraig Burleson, Jessica Dunbar & Kim Boyd (ClinicNET's last Board Chair). NOW is the time to reconvene and chart the plan for next steps for a collective voice for community safety net clinics!  PLEASE PRIORITIZE THIS ENGAGEMENT…your voice is essential!  If you are not able to attend in person please join us virtually via Zoom:

• Join from PC, Mac, Linux, iOS or Android: https://zoom.us/j/337894111
• Or iPhone one-tap (US Toll):  +16465588656,337894111# or +14086380968,337894111#
• Or Telephone: Dial: +1 646 558 8656 (US Toll) or +1 408 638 0968 (US Toll), Meeting ID: 337 894 111

What's happening on the national level with health care - we know more than we did last week!

The American Health Care Act (AHCA), the ACA replacement plan from the Congressional House Republicans, was finally introduced earlier this week. They are seemingly trying to push the bill through prior to the Congressional Budget Office releasing its score which ultimately shows how much it will cost and its impact. The plan essentially eliminates the individual mandate and Medicaid expansion. Below are a few sources of information that outline some of the specifics:

• Vox - The American Health Care Act: the Republicans’ bill to replace Obamacare, explained
• Politico - GOP unveils Obamacare replacement amid sharp party divide
• Colorado Health Institute - ACA vs. AHCA: How They Stack Up
• Colorado Center on Law and Policy (CCLP) - GOP HEALTHCARE PLAN – WHAT IT WOULD MEAN FOR COLORADO

The Colorado Consumer Health Initiative's Protect our Care Colorado Campaign coalition met on Tuesday to learn more about what is happening on the national level, check out the following presentations:

• Devin Zatorski (TRP): ACA Repeal & Replace: Where Do We Stand?
• Elisabeth Arenales (CCLP) : Medicaid & ACA Repeal and Replace

You can take action at ProtectOurCareCO.org 

Colorado Senator Cory Gardner joined three other Republican Senators in signing a letter to Senate Majority Leader Mitch McConnell addressing proposed Medicaid changes. This article from The Hill summarizes the letter.

State Legislative session continues!

Thanks to a contract with Frontline Public Affairs, community safety net clinic directors are receiving periodic email updates on the activities in the current 2017 State of Colorado Legislative Session. Click here to view a 2017 bill tracker specifically for community safety net clinics.

Part of the state legislature's work includes the 17/18 State Budget (aka the long bill). The Colorado Primary Care Alliance continues its efforts to ensure that the partial bump for Medicaid primary care continues for the next fiscal year, and so far so good. We do anticipate this will be the final year of this bump as the State is moving toward alternative payment models for primary care.

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

HCPF recently launched a new Claims Payment System, the Colorado interChange, for processing payments for Health First Colorado (Medicaid) and Child Health Plan Plus (CHP+). In addition, a new Provider Web Portal and a new Pharmacy Benefits Management System (Pharmacy Point of Sale system) were also recently launched. This was not only a transition to new systems, but to new vendors and new processes. The transition appears to be rough; you, along with other clinics, may be experiencing problems!

"There are a number of resources available on the Department’s website. Here they are in one place:

Provider Web Portal

Provider Web Portal Recorded Webinars

Provider Web Portal FAQs (scroll down webpage) and Web Portal Cheat Sheets:

·         Copy, Adjust, or Void a Claim

·         Delegates

·         Provider Maintenance

·         Updating your EFT/ERA Information

·         Validating a Trading Partner ID (TPID)

·         Verifying Member Eligibility

Provider Resources – includes updates on suspended claim status.

Go-Live Guide – identifies changes to Late Bill Override dates on page 6. Please check the updated billing manual for timely filing rules.

Other notes:

·         There is a resolution for denials due to  EOB 1473 – ‘Multiple Provider Locations for Billing Provider Specialty.’ These claims will need to be rebilled starting tomorrow morning 3/10/17. This will be communicated out on the web portal.

·         Submitting claims in provider web portal – the error message when submitting claims has been resolved.

·         An additional financial cycle ran on Tuesday 3/7, in addition to the first financial cycle which ended on Sunday night at 7pm.

·         To register for an account on the Provider Web Portal, the display name cannot have a space (e.g. JohnDoe not John Doe). Please see this work-around for more information.

·         HPE wait times and dropping of calls (not on purpose) is HPE’s highest priority; hiring and training additional agents

o   Providers can check member eligibility through an automated voice system, call 1-844-801-8478.

o   Otherwise, continue to call 1-844-235-2387 or visit the Provider Resources website."

CSNC Strategy Session March 20, 1-4pm

WE STILL NEED YOUR VOICE IN ALIGNING FUTURE WORK ON BEHALF OF COMMUNITY SAFETY NET CLINICS (CSNCs)!

Clinic directors please attend a facilitated strategy session on Monday, March 20, 1:00-4:00pm at COPIC (7351 E. Lowry Blvd., Denver) to hear updates on outreach with health funders, community stakeholders and partners from Kraig Burleson, Jessica Dunbar & Kim Boyd (ClinicNET's last Board Chair). NOW is the time to reconvene and chart the plan for next steps for a collective voice for community safety net clinics!  PLEASE PRIORITIZE THIS ENGAGEMENT…your voice is essential!  If you are not able to attend in person please join us virtually via Zoom:

• Join from PC, Mac, Linux, iOS or Android: https://zoom.us/j/337894111
• Or iPhone one-tap (US Toll):  +16465588656,337894111# or +14086380968,337894111#
• Or Telephone: Dial: +1 646 558 8656 (US Toll) or +1 408 638 0968 (US Toll), Meeting ID: 337 894 111

What's happening on the national level with health care?

Although there are lots of conversations taking place on many fronts about the fate of the Affordable Care Act (ACA) and what might, or might not come next, we really know nothing for sure yet. To that end, however, please be aware of a few important Colorado efforts relative to federal health policy:

• The Colorado Health Institute has launched a federal health policy project called 'Re: ACA'.
  
  
• The Colorado Consumer Health Initiative is coordinating a newly formed Protect our Care Colorado Campaign. Click here to join the coalition & consider attending the March 7, 9:00-11:00am coalition meeting to learn more about what is happening at the federal level on key health policy issues and how advocates can work together to protect the programs that are vital to our health care system. Also, be sure to check out  the Protect Our Care Colorado Toolkit! 

• The newly formed Colorado Health Policy Coalition is a broad & diverse group of stakeholders dedicated to proactively positioning Colorado to shape the federal conversation about the future of health care in America."The goals of this effort were to (a) educate, engage and serve as a resource to coordinate and support advocacy efforts of a broad cross-section of stakeholders and (b) help influence/shape the thinking of Colorado’s state and federal lawmakers’ about impending changes in federal health policy. Specifically, we coalesced around the goal of ensuring that policymakers do not repeal the Affordable Care Act without a clear path forward for an alternate health policy framework for our country that is rational, practical and grounded in shared values. The coalition has an informal Steering Committee and is being supported by Cody Belzley & Michele Ames through funds from the Denver Metro Chamber of Commerce, Colorado Hospital Association & Colorado Health Foundation." 

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

• At a Glance - February 2017 (At a Glance is a HCPF publication which provides information on major initiatives including policy changes and program updates.)
• Medicaid Provider Bulletin - March 2017
• Learn more about Medicaid's (Health First Colorado) Accountable Care Collaborative (ACC) and ACC 2.0 (July 1, 2018 start). Additionally, learn more about the related Primary Care Payment Reform work!
• Learn about the proposed changes to the Colorado Indigent Care Program (CICP)! New provider application will be released April 14 and due May 15. 
• Primary Care Fund - 17/18 application has been released and is due May 25!
• Colorado State Innovation Model (SIM) - SIM RFA for Cohort 2 open now!

State Legislative Session!

Thanks to a contract with Frontline Public Affairs, community safety net clinic directors are receiving email updates on the activities in the current 2017 State of Colorado Legislative Session. (The state legislature is scheduled to be in session January 11 - May 10, 2017.) Click here to view a 2017 bill tracker specifically for community safety net clinics.

Immigrant health stories needed

The Colorado Coalition for the Medically Underserved (CCMU) and the Coalition for Immigrant Health are looking for storytellers to work with media as we receive requests. They would love storytellers from two perspectives: 

1. Patient stories (especially patients who live in these counties: Alamosa, Baca, Bent, Conejos, Costilla, Crowley, Custer, Huerfano, Kiowa, Las Animas, Mineral, Otero, Prowers, Pueblo, Rio Grande, Saguache, Adams, El Paso, and Jefferson), and 
2. Health care leader perspective (including but not limited to providers, administrators, CEOs).

CCMU will work one-on-one with storyteller volunteers to prepare them for media interviews, and will also work to protect storyteller identity if storyteller would prefer to conceal name and photos (e.g., if a person is an immigrant). These stories will help boost much-needed attention among constituents, legislators, and other decision-makers on how much we value health for immigrants in Colorado. Once you've expressed your interest, you are free to decline or accept any opportunity that comes your way. Interested storytellers should contact Aubrey Hill (aubrey.hill@ccmu.org).