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

Update from the Colorado Health Policy Coalition:

"(1) CBO released analysis of Alexander-Murray Proposal - Yesterday the Congressional Budget Office released its analysis of the bi-partisan health care stabilization act showing that the measure would reduce the deficit $3.8 billion during the 2018 - 2027 time period and not have a significant impact on the number of Americans with health insurance. You can read the CBO analysis here and read coverage of where things stand with Alexander-Murray from Politico and The Hill. 

(2) White House and Congressional Leaders Focusing on Taxes, Not Health Care - President Trump joined Senate Republicans for lunch on Tuesday to discuss priorities. Politico reportsthat the focus on the conversation was on tax reform plans and there was very little talk of health care. Then yesterday, House Speaker Paul Ryan told Reuters that neither the stabilization proposal nor a repeal and replace measure are likely to move forward in 2017. 

(3) Judge denied request to force feds to resume CSRs - As you know, 18 Attorneys General are taking legal action to try to force the federal government to continue the cost sharing reduction (CSR) payments that the Trump administration halted on October 12. Yesterday, a federal judge denied a request for a preliminary injunction in the case. Despite yesterday's ruling, California Attorney General Xavier Becerra, who is leading the legal effort on behalf of these 18 states, vowed to continue fighting to reinstate the CSRs. Read more about the legal challenge in Kaiser Health News and Health Affairs. "

#FundCHIPColorado

Update from the CHIP Coalition:

"A report from the Georgetown Center for Children and Families discussing the implications of Congress’s delay in financing the CHIP program. The report highlights a number of important issues in Colorado:

• Colorado estimates that it will cost the state $300,000 to turn enrollment on and off, which would further deplete remaining funds.
• Though Colorado has funds to continue the program until early 2018, it plans to begin sending notices to CHIP enrollees before the end of the year.
• The upper income range of Colorado’s CHIP programs (206 to 250 percent of the federal poverty level) is financed by a provider fee that is contingent on federal funding – this means that absent federal action or a change is state law, it will not be possible to continue CHIP coverage for this group of enrollees beyond the end of federal CHIP funding in early 2018.

Representatives of the Colorado CHIP Coalition met with the Medicaid Department to learn more about their communications plans. The Department is planning to send some program information to CHIP families in mid-to-late November. If Congress does not act before the end of the year, official coverage termination notices will go out at the end of December, letting families know that CHIP coverage will be ending at the end of January 2018 and that they should look for other coverage options for their families. The Department has updated their future of CHP+ website to include information for members, providers, stakeholders and advocates, and county and eligibility partners. The website is here: https://www.colorado.gov/pacific/hcpf/future-child-health-plan-plus-chp. We will stay in touch with the Department and are continuing to develop materials and advocacy strategies directed at our Federal delegation to urge swift CHIP reauthorization. We will be in touch with additional information in the coming weeks."

Take Action on the National Health Service Corps, FQHCs, and CHIP

Update from the Association of Clinicians for the Underserved:

House to vote this week to extend funding for the NHSC, CHCs and CHIP. Action needed to protect and strengthen the NHSC! 

House leadership announced a planned vote for this week on legislation to extend funding for the Children’s Health Insurance Program (CHIP), Community Health Centers, and the National Health Service Corps. The House was expected to vote earlier, but the vote was delayed as Members attempted to find a compromise on how to pay for extending these programs. Unfortunately, Republicans and Democrats have so far been unable to agree on these “pay-fors”. Although not yet confirmed, we expect a vote this week on the CHAMPION Act (H.R. 3922) which calls for a two-year level-funding extension for the NHSC and the Community Health Center program.

Democrats have so far voiced their opposition to the “pay-fors” in these bills. If that remains the case, the bills would likely pass the House along party lines. If the bills do pass the House this week, they will move to the Senate, which will undoubtedly propose changes. These bills will need to avoid a filibuster in the Senate, so our expectation is that they will become more bipartisan in order to be enacted.

As Congress prepares for what will be critical votes on these bills, we need to ramp up our advocacy efforts to keep up the pressure on Congress to do what is necessary to fund the NHSC and all the other programs. So far, we have had more advocates than ever before contact Members of Congress to support the NHSC. As a result of your unwavering commitment to the Corps, we are close to our goal. Now, we need to once again weigh in with every Member of Congress to get funding for the NHSC across the finish line.

Call, tweet at, and email your Representatives today. Ask them to show their support for the NHSC by voting to extend and increase funding the NHSC.

Thank you for your efforts to date. Keep up the good work!

TAKE ACTION NOW! S

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

Stop sabotage of the ACA!

Unfortunately, we knew the failure of repeal wouldn't be the only threat to health care this year. The Trump Administration has taken several actions in the last 2 weeks to directly undermine the Affordable Care Act. We need you to call Congress and tell them to stop this sabotage and support the bipartisan stabilization process in the Senate.

Here are the sabotage efforts that have happened recently:

• Contraception Coverage Rollback: The Dept. of Health and Human Services released new rules allowing virtually any employer to claim a religious or "moral" exemption and stop providing contraceptive coverage in their insurance plans.
• Executive Order: The Trump Administration signed an Executive Order to expand and exempt "association health plans" from meeting basic ACA consumer protections like essential health benefits requirements.The Executive Order also called for short-term, "limited liability" insurance plans (sometimes called mini-med plans) to be offered on a year round basis instead of only 90 days at a time.
  
  This order:
  • Promotes bottom-of-the-barrel insurance plans that leave consumers open to huge financial risks and plans that could deny basic coverage for health services like mental health, maternity care or other services.
  • Could destabilize the individual and small employer insurance markets, as younger and healthier individuals and companies opt for these low-quality, junk insurance plans, leaving the fully-insured market facing increasing premiums from an older, sicker risk pool.
    • This Executive Order has to go through the regulatory and public comment process that will take some time and present an opportunity for advocates to weigh in.

You can read our statement on the executive order here

• Stopping Cost-Sharing Reduction Payments: The Trump Administration decided to stop what are called "cost-sharing reduction" payments to insurance companies last Thursday night.Under the Affordable Care Act, insurance companies are required to provide low to moderate income consumers cost-sharing reductions that lower their out-of-pocket costs like copays and deductibles in marketplace plans to make it more affordable to use health care services. The Administration stopped the payments that reimburse insurance companies for providing this additional assistance.
  
  This decision:
  • Causes insurance companies to raise their premiums to make up for the lack of reimbursement payments.
  • Helps no one and hurts thousands of Coloradans by raising their premiums.
  • Harms Colorado families that don't qualify for tax credits and purchase insurance on the individual market.
  • Destabilizes the insurance market and severely undermines affordability days before open enrollment starts.
  • Increases costs to taxpayers by nearly $200 billion over the next 10 years because the government will end up paying more in premium tax credits to offset the increases in premiums.
    
    You can read our statement on this decision here.

Congress can stop this sabotage by supporting efforts to restore the funding through the bipartisan stabilization effort being led by Senators Murray and Alexander.

Call our Senators to tell them to stop the sabotage and support the bipartisan stabilization effort!

Call your Senators:

Senator Gardner -  Denver: (303) 391-5777 DC: (202) 224-5941
Senator Bennet - Denver: (303) 455-7600 DC: (202) 224- 5852

Call your Representative too:

Representative Coffman - Aurora (720) 748-7514, DC: (202) 225-7882
Representative Tipton - Durango: (970) 259-1490, DC: (202) 225-4761
Representative Buck - Greeley: (970) 702-2136, DC: (202) 225-4676
Representative Lamborn - CO Springs: (719) 520-0055, DC: (202) 225-4422
Representative Polis: Boulder - (303) 484-9596, DC: (202) 225-2161
Representative Perlmutter - Lakewood: (303)274-7944 DC: (202) 225-2645
Representative DeGette - Denver: (303) 844-4988, DC: (202) 225-4431

Social Media:

• @SenCoryGardner If you really care about increasing premiums #StopTheSabotage  #ProtectOurCare
• @SenCoryGardner Support the bipartisan stabilization plan from Sen. Murray & Alexander and #StopTheSabotage
• @SenCoryGardner Higher premiums Coloradans pay from stopping CSR payments are on you. You chose not to fund them #StopTheSabotage
• #StopTheSabotage @SenCoryGardner and pass a bill to fund CSR payments and stabilize individual market. #ProtectOurCare
• @SenBennetCO Please continue to advocate for a bipartisan bill to stabilize insurance market to #StopTheSabotage

Source: Protect our Care Coalition

#FundCHIPColorado

Update from the CHIP Coalition:
"...the week before last, bills to reauthorize CHIP passed out of the committees of jurisdiction in both chambers. The Senate bill to protect CHIP passed out of the Senate Finance Committee without dissent. The House bill largely mirrored the Senate bill’s policy on CHIP, but included partisan offsets, including a policy (related to third-party liability for Medicaid) that could reduce access to high-value Medicaid services such as pediatric preventive care and care for pregnant women. The House bill passed out of the Energy and Commerce committee with Republican votes only. Last week, only the House was in session and no further progress was made on CHIP. The Senate will be in session this week (while the House is in recess) and we hope that the Senate moves their bill to the floor for a full vote this week. This update from the Georgetown Center for Children and Families provides additional details on likely Congressional next steps. It remains unclear what the vehicle will be to get CHIP reauthorization across the finish line. We know that some states are already very low on CHIP funds and will need to start ending coverage next month. HCPF has stated that unless Congress acts, kids and pregnant women in Colorado will begin losing their health care in just three months, at the end of January.

You can read a Denver Post editorial on the CHIP program here – and watch news clips about the importance of the program to one Colorado family here and here."

Advocacy tools:

• email action alert text
• Contact and social media information for the Colorado Congressional delegation, and sample content for Twitter and Facebook
• Facebook graphics

Take Action on the National Health Service Corps

Urge Your Representative to cosponsor H.R. 3862 to save and strengthen the NHSC. Email, tweet and/or call today!

TAKE ACTION NOW!

Members of the House of Representatives are back home in their districts this week but a vote on legislation that will decide the future of the National Health Service Corps is expected when they get back to Washington next week. Now may be our last, best chance to deliver our message to Save the NHSC! Representatives G.K. Butterfield (D-NC) and Chris Stewart (R-UT) have introduced H.R. 3862, the "National Health Service Corps Strengthening Act of 2017” which will not only preserve the Corps, but also proposes modest funding increases that will strengthen the field by enabling even more primary care providers to practice in underserved communities.  While this bill is encouraging, it does not offer any certainty that Congress will act quickly to resolve the NHSC funding cliff. We need every Member of Congress who supports the NHSC to cosponsor H.R. 3862.  While we hope you will send an email, please also make a call or tweet at them to have an even greater impact and let your Representative know how important the NHSC is to your community. Urge them to cosponsor H.R.3862. You can also find a public meeting near you to engage with your Representative in person. Ask them to support this legislation and sign on as a cosponsor.

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

Colorado interChange: Resources for your Membership Week of October 19, 2017 We'll use this newsletter to provide you with updates on the implementation of the Colorado interChange, including topics you might be hearing from your members as well as content for your membership newsletter and general updates on progress.  Provider Buzz Here's a look at hot topics for providers and others: There is a system issue which prevents the Colorado interChange from processing some retroactive changes to a Health First Colorado (Colorado's Medicaid Program) and Child Health Plan Plus (CHP+) member's eligibility span. If the member has already contacted the Member Contact Center and obtained the Proof of Insurance, the provider should accept this as eligibility verification and render services. The eligibility update will take 2-3 business days to appear in the Colorado interChange. Once the fix is made, the provider will be able to submit or resubmit claims for services to the member. For more detailed information, please refer to this fact sheet.   Financial assistance in the form of interim payments is still available to enrolled providers experiencing billing difficulties. Providers experiencing hardship should request these payments by calling the Provider Services Call Center at 1-844-235-2387, selecting option 2 to "speak with an agent" and then option 4 to learn about interim payment options. The Department has developed a detailed FAQ to assist providers in learning more about interim payments. At this point, nearly all providers should be submitting all claims -- including those claims with attachments -- electronically. Providers who submit less than five claims each month may continue to submit a request form. For those providers continuing to have issues with their use of the portal, the Department has lengthened the timely filing deadline extension through May 2018. News You Can Use Here's some content for membership newsletters: Resources available to assist with Colorado interChange questions There are many resources available to help you learn more about the Colorado interChange, see more about known issues with the system and receive updates on fixes and additional information. The primary areas you can find this information include: The Known Issues & Updates web page is frequently updated with known system issues and work arounds. Issues are categorized by service type so you can more easily find issues affecting your business. While this is not an all-inclusive list of all system issues, it is regularly updated and includes the vast majority of known issues and updates. The Provider Resources web page is an archive of all Colorado interChange related email blasts previously sent to providers, which contain helpful resources and information. The Fiscal Agent and Colorado interChange web page houses resources for getting better acquainted with the new Provider Web Portal, including Quick Guides, trainings and FAQs.  Colorado interChange Numbers Since March 1, 2017... Nearly $5 billion paid to providers 32 million claims have been processed  In our latest financial cycle on Friday, October 13... $118.5 million paid to providers 795,272 claims processed As a reminder, the Department frequently updates its Known Issues & Updates web page with new issues, work arounds and resolution ETA. There was an error in the October 5, 2017 report of this section. Below are the correct numbers.  Since March 1, 2017... (As of October 5, 2017) $4.5 billion paid to providers 25 million claims have been processed  Please do not reply to this email; this address is not monitored. To sign up for this email list, click here.

Medicaid Primary Care Alternative Payment Model

"The Department of Health Care Policy and Financing is excited to provide you with updated information on the Primary Care APM:

APM Resources

The APM Survival Guide is now available on the Department's website here.  The Guide provides a good overview of the information providers need to know to begin getting ready for the APM and here is a link to detailed resources (measures, code set, timeline, and model) on the Department's website. 

Implementation Workgroup

As the Department of Health Care Policy & Financing moves forward with Alternative Payment Model for Primary Care (APM), a workgroup is forming to assist with the implementation of the APM.  Similar to the process used to design the APM, the Department is looking for representation from primary care physicians, primary care practice coordinators, office managers, and Regional Care Collaborative Organization representatives.  The group would provide feedback and input on how best to implement the APM and help the Department understand the impact of operational decisions. 

The time commitment would be one 60-90 minute meeting every other month.  A kick-off meeting will be scheduled in November and meetings scheduled every other month thereafter.  There would be a call-in option for those unable to attend in person. 

If you are interested in participating in the Implementation Workgroup please respond to this email.

Please don’t hesitate to reach out with any questions, comments, or concerns.

Thank you,

The Delivery System Reform Team

HCPF_PrimaryCarePaymentReform@state.co.us"

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

From the CO Health Policy Coalition on October 12, 2017:

"In response to unsuccessful efforts in Congress to repeal and replace the Affordable Care Act, this morning President Trump signed a wide-ranging Executive Order: Promoting Health Care Choice and Competition Across the United States. The broad measure seeks to expand access to lower-cost, less comprehensive private insurance, allow employers to give employees money to buy individual coverage and slow consolidation of health plans and hospitals. To accomplish these things, the Order directs the Departments of Treasury, Labor and Health and Human Services to work together to revise regulations and guidance in a number of areas. As such, this signals the beginning of a regulatory policy-making process that will unfold over the coming weeks and months. The specific timeline for implementation of new policies and the impact on insurance markets for 2018 is unclear. The White House's summary of the Executive Order, talking points and frequently asked questions is available here. 

Summaries and analysis from other sources are just now becoming available. A few worth noting include:  

Trump's Order Advances GOP Go-To Ideas to Broaden Insurance Choices, Curb Costs, Julie Appleby, Kaiser Health News
Trump Executive Order Expands Opportunities for Healthier People to Exit ACA, Timothy Jost for Health Affairs Blog

Additionally, organizations are beginning to release statements in response. I have compiled a few from key organizations here for your review. 

U.S. Chamber of Commerce 

Americas Health Insurance Plans (AHIP)

American Hospital Association

Families USA"

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

• CCHAP Practice Manager Newsletter - Oct. 11, 2017
• Click here to read the latest from HCPF re: CHIP
• At a Glance - September 2017

Dental Advisory Committee Seats Available:
"As you may be aware, the Colorado Dental Health Care Program for Low-Income Seniors (the Senior Dental Program) is to promote the health and welfare of Colorado’s low-income seniors. The Senior Dental Program provides access to dental care to low-income seniors that meet the following criteria:
·         60 years of age or older;
·         Lawfully present in Colorado;
·         Economically disadvantaged (income is at or below 250% of the most recently published federal poverty level for a household of that size); and
·         Not eligible for dental services under Health First Colorado (Colorado’s Medicaid Program) or the Old Age Pension Health and Medical Care Program, and who do not have private dental insurance.

The Senior Dental Program is overseen by the Department of Health Care Policy and Financing (the Department) with the oversight of the Dental Advisory Committee (DAC). The DAC serves as a forum where the Department and the stakeholder community can discuss the Senior Dental Program along with making recommendations to the Medical Services Board.

The Committee members are asked to meet at least quarterly to receive updates, review, and comment on proposals received from Senior Dental Program grantees. Members will be appointed by the Department’s Executive Director and will be appointed to 3-year terms. There are currently two seats available and the Department is seeking candidates to fill the following interest areas on the DAC:

1.  A representative from a safety-net health provider that is not a community health center, as defined in the Federal “Public Health Service Act”, 42 U.S.C. sec.254b and
2.  A consumer advocate.

If you, or someone else you may know, is interested in participating on the Committee, please send a detailed email describing the following:

·         Which interest area you would like fill;
·         A brief description of your relevant experience;
·         Your role with your current organization and your relationship with low-income seniors; and
·         Why you would like to serve on the Committee. 

In addition to the information requested above, feel free to include a current resume or any supplemental information you think would be helpful for our decision.

Please email your expression of interest and any supporting materials to my attention at Chandra.vital@state.co.us with the subject: Dental Program Advisory Committee Membership.  Please respond by October 31, 2017. If you have any questions or need any additional information, please contact me directly via email.

Thank you,
Chandra Vital
Senior Dental Grant Program Administrator
Finance Office

P 303.866.5506  I  F 303.866.4411  I  State Relay: 711
1570 Grant Street, Denver, CO  80203
chandra.vital@state.co.us  I  Colorado.gov/hcpf"