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

• FY 2018-19 Primary Care Fund (PCF) application with timeline and important dates
• No Show Surveys:The Accountable Care Collaborative (ACC) Program Improvement Provider & Community Issues (P&CI) Subcommittee is gathering data statewide in response to ongoing concerns about the medical, operational and financial impact of No Show appointments on practices and on patients.  The appointed workgroup hopes to obtain an accurate snapshot of the current No Show issue in Colorado and provide recommendations to the ACC Program Improvement Advisory Committee to address this issue.
  
  There are two surveys: one for practice sites and one for members (in both English and Spanish). The provider survey was developed and reviewed by primary care providers and other P&CI subcommittee members, and the member survey was reviewed and piloted by the Department of Health Care Policy & Financing’s Member Experience Advisory Council.
  
  All surveys are anonymous and will not impact any practice or member in any way.  Practices who wish to identify and share policies will be able to do so, but specific practices will not be reported in the outcomes.
  
  On February 16^th, the workgroup will begin tabulating responses and report back to the Provider & Community Issues Subcommittee meeting in March with observations and recommendations. These will be available in the meeting documents and minutes. More information about the ACC Program Improvement Advisory Committee and Subcommittees can be found here.
  
  Provider Survey: https://www.surveymonkey.com/r/PCINoShowSurvey-ProvidersMember Survey (English): https://www.surveymonkey.com/r/NoShowSurvey-Members-English
  Member Survey (Spanish): https://www.surveymonkey.com/r/NoShowSurvey-Members-Espanol Completion Deadline: Friday, February 16, 2018

Tell Congress to Fund the NHSC, Health Centers by Feb 8th Deadline!

The recent government shutdown has shown us that our patients ability to access healthcare is in political crossfire. Currently, a Continuing Resolution (CR) has been passed to temporarily fund the government.

Congress is now tasked with putting together and passing a budget to fund federal programs by the Feb 8th deadline--otherwise, we face yet another shutdown. This budget legislation serves as the perfect vehicle through which Congress can act on funding the National Health Service Corps and other vital healthcare access programs.

We must seize this opportunity and act.

From now till Feb 8th, we need to get loud and demand that Congress:

• Fully funds critical health programs like the The National Health Service Corps (NHSC), Health Centers Program, and Teaching Health Centers in their budget.

The NHSC and Health Centers Program have both had long-standing bipartisan support. Congress needs to fully fund critical health access programs like the NHSC and Health Centers and Teaching Health Centersimmediately.

Please CONTACT your officials now!

Source: Association of Clinicians for the Underserved

#FundCHIPColorado

CHIP Coalition Update:

"Thank you all so much for your dedicated partnership in fighting for CHIP funding over the last six months. Your efforts to generate calls, emails and postcards to our federal delegation, share information on social media, get news articles published, inform state contingency plans, and support emergency state supplemental funding all helped to keep this issue top of mind at the federal and state level and helped to mitigate the uncertainty Colorado’s working families were facing. Thank you, thank you, thank you.

Click here for a letter that the CHIP Coalition sent today to our federal delegation, thanking them for their support of CHIP, and urging them to continue working to ensure funding for other key health priorities including community health centers and voluntary maternal and infant home visiting services.

The Department of Health Care Policy and Financing has posted an update to their Future of CHP+ website that includes a sample of the letter they are sending to CHP+ members letting them know that their coverage will continue.

Our national partners have continued to analyze the text of the Continuing Resolution this week and have published some additional blog posts:

CHIP Extended for 6 Years – A Huge Relief but Long Overdue

HEALTHY KIDS ACT (Helping Ensure Access for Little Ones, Toddlers and Hopeful Youth by Keeping Insurance Delivery Stable Act)

Relief for Families: After More Than 110 Days, Congress Extends CHIP

Congress Must Now End the “CHIP Cliff”

This is likely our last email to the 2017/18 Colorado CHIP Coalition. If you would like to stay engaged in these types of issues going forward, we encourage you to sign up for the All Kids Covered email list. The AKC Coalition is finishing up a strategic visioning process and will have greater clarity around our collective work going forward in the coming months, but will continue to serve as a table that can rally to defend these types of crucial health care programs for Colorado kids. You can sign up here: http://www.allkidscoveredcolorado.org – bottom left."

Government Shutdown Imminent!

Govt. Shutdown Imminent: Tell Congress to STOP PLAYING GAMES with our Patient's Healthcare!

CALL CONGRESS NOW!

In order to avoid a government shutdown, the Senate must vote by midnight tonight to pass a Continuing Resolution (CR) that will keep the government open for business. Congress’s failure to act has gotten us to this point and has put our patients ability to access healthcare in limbo. We need to make it clear that we are fed up with inaction and demand that Congress: Fund critical health programs like the National Health Service Corps (NHSC) and the Health Centers Program As we said before, the NHSC’s annual budget is currently $310 million – an amount that funds less than 40% of the applicants willing to serve in areas of provider shortages. Unless Congress acts, thousands of NHSC providers will have little choice but to leave communities that need them most. Millions of people – insured and uninsured – will find themselves with no one in their communities to provide the health care they need. The way forward is a no-brainer. Congress needs to fully fund critical health access programs like the NHSC and Health Centers immediately. We need your help calling Congress to safeguard our patient’s healthcare! Call your senators now. Let’s keep these priorities on their radar.

Source: Association of Clinicians for the Underserved We are hours away from a government shutdown that shouldn't be! Last night, House Republicans passed a short-term continuing resolution to fund the government for four weeks. While it funds CHIP (Children's Health Insurance Program) for 6 years, which is crucial, it fails to provide a solution for DREAMERS, and fails to fund community health clinics, the health services corps, and teaching hospitals, whose funding also expired in September. Community Health Centers are struggling to avoid service cutbacks in underserved and rural areas because of this! The CHIP program has been neglected for months after funding expired in September, and now is being used as a political bargaining tool in an unacceptable game of chicken over the shutdown of the federal government. A government shutdown shouldn't happen. Pitting health care for kids and pregnant moms against a solution for DACA (Deffered Action for Childhood Arrival) youth, meanwhile funding the government for only weeks at a time, is unconsionable and irresponsible governance, especially when there are bipartisan agreements just waiting for a vote. Call your Senators and Representative and tell them to vote for the bipartisan agreements to fund CHIP, reinstate DACA, and keep the government funded! Senator Gardner -  Denver: (303) 391-5777 DC: (202) 224-5941 Senator Bennet - Denver: (303) 455-7600 DC: (202) 224- 5852 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 Source: Protect Our Care Coalition

2018 Federal Poverty Level (FPL) Figures

2018 Federal Poverty Level (FPL) Figures have been released:  https://aspe.hhs.gov/poverty-guidelines

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

• Important update on SIM cohort-3 application
• Accountable Care Collaborative Phase II Update
• CCHAP Practice Manager Newsletter - January 17, 2018 - includes great info about various state issues

Colorado interChange: Resources for your Membership Week of January 18, 2018

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

Provider Buzz

Here's a look at hot topics for providers and others: Related to the Colorado interChange Effective January 1, 2018, the Department will be enforcing new Medicaid regulations that require all ordering or referring physicians or other professionals providing services must be enrolled as providers, and that Medicaid must require all claims for the payment of items and services that were ordered, referred, and prescribed to include the National Provider Identifier (NPI) of the ordering, referring or prescribing physician or other professional. The Department will not pay for new prescriptions written on or after January 1, 2018 if the prescriber is not enrolled with Colorado Medicaid. If a prescriber does not wish to enroll with Colorado Medicaid they should begin referring their patients to a prescriber that is enrolled. The Department has been identifying and making direct calls to these unenrolled providers since October 2016, has sent many faxes to pharmacies about the implementation and has been noticing pharmacies. Other hot topics from the Department On December 21, 2017, the Joint Budget Committee approved Governor John Hickenlooper's request for one-time, short-term funding to extend funding of CHP+ at least until February 28, 2018. An exact end date for CHP+ in Colorado is not known at this time because of changing legislative action. The Department is currently analyzing how the December federal Continuing Resolution passed by Congress may impact the CHP+ program in Colorado. Once the Department's analysis is complete, we will update our Future of CHP+ Provider Resources web page. Visit this page frequently and sign up for our Future of CHP+ newsletter for updates straight to your inbox.  Three Health First Colorado co-pay amounts changed January 1, 2018 as part of SB 17-267 implementation: Outpatient hospital visit co-pays increased from $3 to $4 Non-emergency ER visit co-pay increased from $3 to $6 Generic drug co-pay increased from $1 to $3 Please see the December Provider Bulletin for more information. Providers, please be aware that Health First Colorado members are liable for no more than 5 percent of their monthly household income towards co-payments per month. The Provider Web Portal will display whether a member is co-pay eligible as of the date it is checked. Please note: Members may reach their 5 percent co-pay maximum for the month before the Provider Web Portal reflects this because of the time allowed for providers to submit claims. Please consider this possibility if Health First Colorado members believe they have met their monthly co-pay maximum, but the Provider Web Portal indicates the member owes a co-pay amount at the time of their visit. Please see the December Provider Bulletin for more information. The Department is moving forward with the implementation of the Alternative Payment Model for Primary Care (APM). The survey to select measures in the model is open. A link to the survey is available on the Department's website. The website also has pre-survey instructions, links to resources, including the APM Survival Guide, and a short video demonstrating how to use the APM model. The survey will remain open through January 31, 2018.

News You Can Use

New FAQs and webinars available for Colorado interChange New resources are coming on line to assist you with learning about hot topics and important issues. Over the last couple of months, new information has been added on the following topics in various formats: Revalidation webinar Revalidation best practices Also available are new frequently asked questions on a variety of areas including revalidation and enrollment backdating, provider identification and taxonomy as well as timely filing.

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

• SIM helps prepare practices for success with APMs 
• Medicaid Primary Care Payment Reform - read the survival guide & complete the APM Measure Selection Survey by January 31st!

CHIP, But Not NHSC, To Be Included in Next Funding Bill Unless We Act NOW!

Update from the Association of Clinicians for the Underserved:

TAKE ACTION NOW!

"We need your help urging Congress to extend CHIP as long as possible AND include the other critical health access programs like the National Health Service Corps, Health Centers and the Teaching Health Centers programs. The debate over funding offsets has evaporated with the new report from the Congressional Budget Office. Please urge both your Senators and Representatives to include funding for the NHSC as they move a CHIP bill in the next week. The time is now to fully fund the National Health Service Corps! Congress delayed action on reauthorizing and funding CHIP, NHSC, Health Centers, the THC program and other critical health care access programs due to the inability to find bipartisan funding sources. Past funding for each of these programs expired last October, with Congress only recently passing a short-term patch for each as last year came to a close. Earlier this week, the CBO revised their view of the cost of an 5 year extension of the CHIP program from $8.2 billion to $800 million (a decrease of 90%). In fact, they also said that if you extended CHIP for 6 years it would cost nothing, and if you did it for 10 years it would actual save the federal government over $6 billion. Suddenly Congress is energized to move a CHIP bill coupled with the government funding bill by next Friday, Jan. 19. We are very concerned that they will move a CHIP-only extension, leaving the other critical programs, like the NHSC, behind."

#FundCHIPColorado

Update from the CHIP Coalition:

"Negotiations are ongoing in Congress on a long-term extension of CHIP funding. Politico reports that policymakers are considering whether CHIP funding should be extended for five, six, or even ten years. The Congressional Budget Office (CBO) last week released a new score for the bipartisan proposal for a five-year extension of CHIP funding, estimating that the proposal would cost $800 million rather than $8.2 billion. Yesterday, CBO released an estimate of the cost of extending CHIP funding for ten years, and found that a ten-year extension would be projected to save $6 billion. These savings are due to recent federal regulatory and legislative changes to health insurance policy, including the elimination of the individual mandate requirement to have health insurance if an affordable option is available to you, that were included in the Republican-backed tax bill that passed Congress late last year.

The vehicle through which CHIP funding could be extended also continues to be under discussion. CHIP could be included in another continuing resolution (CR) to keep the government funded after January 19, when the current CR expires. And the Chairman of the U.S. House Energy and Commerce Committee (Rep. Walden, R-Ore.) stated that he may bring a standalone proposal to extend CHIP funding for six years to the House floor next week."

Colorado Consumer Health Initiative Survey

The Colorado Consumer Health Initiative works so all Coloradans can access affordable, high-quality, and equitable health care. They represent the voices of health care consumers at the capitol, and want to hear about your experiences - so that they can do their best work to make the system work for you. 

Take this 15 minute survey and make your voice heard. All Coloradans are welcomed and encouraged to participate! Responses are completely anonymous. 

In English: http://cohealth.co/2hM8avg 

En Español: http://cohealth.co/2A7wDa2 

SIM seeks your input

"The Colorado State Innovation Model (SIM) and Health First Colorado (Medicaid) need your input on the use of telehealth and e-consults to improve patient access to care and identify barriers to the use of this technology. Please complete a short, telehealth/eConsult survey by Jan. 17, 2018, and encourage your healthcare colleagues to do the same. The information will be used to bolster sustainability of SIM's telehealth efforts. Survey link: https://www.surveymonkey.com/r/YKL3765 that can be shared through your networks."

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

• At a Glance - December 2017
• Colorado interChange: Week of January 4, 2018, Provider Buzz:

Related to the Colorado interChange
Effective January 1, 2018, the Department will be enforcing new Medicaid regulations that require all ordering or referring physicians or other professionals providing services must be enrolled as providers, and that Medicaid must require all claims for the payment of items and services that were ordered, referred, and prescribed to include the National Provider Identifier (NPI) of the ordering, referring or prescribing physician or other professional. The Department will not pay for new prescriptions written on or after January 1, 2018 if the prescriber is not enrolled with Colorado Medicaid. If a prescriber does not wish to enroll with Colorado Medicaid they should begin referring their patients to a prescriber that is enrolled. The Department has been identifying and making direct calls to these unenrolled providers since October 2016, has sent many faxes to pharmacies about the implementation and has been noticing pharmacies.

Other hot topics from the Department
The Department is implementing two new policies related to co-payments. Providers can find details about each of the policies in the December Provider Bulletin. The Department has also recorded an informational webinar. Policy changes include notification of members by mail when their household has met its co-pay maximum, which is 5 percent of the household monthly income and changes to co-pays for outpatient hospital visits, non-emergent emergency room visits and pharmacy co-pays.

The Department is moving forward with the implementation of the Alternative Payment Model for Primary Care (APM). The survey to select measures in the model is open. A link to the survey is available on the Department's website. The website also has pre-survey instructions, links to resources, including the APM Survival Guide, and a short video demonstrating how to use the APM model. The survey will remain open through January 31, 2018.

On December 21, 2017, the Joint Budget Committee approved Governor John Hickenlooper's request for one-time, short-term funding to extend funding of CHP+ at least until February 28, 2018. An exact end date for CHP+ in Colorado is not known at this time because of changing legislative action. The Department is currently analyzing how the recent federal Continuing Resolution passed by Congress may impact the CHP+ program in Colorado. Once the Department's analysis is complete, the resources and information on this page will be updated to reflect the most current information.You can get updates by visiting the Department's Future of CHP+ page and signing up for the future of CHP+ newsletter.

News You Can Use

Using the void claim option in the Provider Web Portal
The void claim option on the Provider Web Portal will only appear on eligible claims. Only paid claims can be voided and the most recent paid Internal Control Number (ICN) must be used to adjust or void. For more instructions on how to adjust or void a claim, refer to the Copy, Adjust or Void a Claim Quick Guide on the Web Portal. As a reminder, providers should be submitting all claims electronically. Please see the November 2017 Provider Bulletin (B1700406) for information on submitting claims with attachments. Denied claims do not need to be adjusted or sent as a request for reconsideration. A denied claim can be resubmitted electronically as a new claim once corrections have been made.

Colorado interChange Numbers
Since March 1, 2017...

$6.5 billion paid to providers
More than 41 million claims processed In our latest financial cycle on Friday, Dec. 29...

$93 million paid to providers
Nearly 800,000 claims processed As a reminder, the Department frequently updates its Known Issues & Updates web page with new issues, work arounds and resolution ETA.

Community Safety Net Clinics “Beyond ClinicNET”

Since May, a Community Safety Net Clinic (CSNC) Steering Committee has been working on creating a path forward for CSNCs post-ClinicNET. Local philanthropic funders are supporting a business planning process enabling CSNCs to re-imagine working together in support of collective core activities and needs. The Steering Committee engaged the Center for Health Progress to help facilitate this effort and they will guide CSNCs through a process that will identify a clear sustainable governance path forward together. Someone from the Center for Health Progress will be contacting clinic directors for feedback and participation. Questions? Contact: Jessica Dunbar, Rocky Mountain Youth Clinics at jdunbar@rmyclinics.org.