ACA Implementation Newsletter & Provider Bulletin

Click here to view the latest ACA Implementation Newsletter.  This publication is designed for eligibility workers and those who are interested in implementation of the eligibility and enrollment provisions of the Affordable Care Act.  Beyond the news sections, information about training and stakeholder engagement opportunities, the Colorado Department of Health Care Policy and Financing added a new section that features answers to reader questions.   

Also, the April Provider Bulletin is now available.  It contains information about the Provider Communication Survey; Third Party Bank Accounts; the Department’s Web site Changes; Client’s Who Need Assistance; Fee-for-Service Providers & ACC Members; NCCI Requirements and Billing Colonoscopies; ColoradoPAR; 2013 HCPCS and Fee Schedule; Physician Supplemental Payments; DME/Supply Providers & NCCI; Waiver Providers & Colorado Choice Transitions; IHS Pharmacies Billing Updates; Seroquel; Update.

March Provider Bulletin and the new "ACA Implementation News

Click here to read the March Provider Bulletin. The index includes:

All Providers.........................................1
Medicare-Medicaid Enrollees.................1
Medicare/Medicaid Crossover Claims....1
Record Retention...................................1
Planning for ICD-10................................2
Second Phase NCCI..............................2
...and more. 

Also, the Colorado Department of Health Care Policy and Financing has a new publication called "ACA Implementation News."  It is meant to "keep county partners, Medical Assistance (MA) sites and other stakeholders informed about Department of Health Care Policy and Financing (Department) activities and opportunities to participate in the implementation of the eligibility provisions of the Affordable Care Act (ACA)."  Click here to read the February 2013 issue.

[Source: Colorado Department of Health Care Policy and Financing]

COPIC provides invaluable coverage through its Volunteer Physician Program

COPIC is invested in the health of Colorado’s safety net community.  Their Volunteer Physician Program offers a volunteer medical professional liability policy that is available to physicians providing volunteer and non-compensated services.   Several basic eligibility requirements apply including:

•     Physician must have a valid, current, unrestricted medical license
•     Physician must be providing services on a volunteer basis without any remuneration ( monetary or otherwise)
•     Physician cannot perform any obstetrical, prenatal, invasive or surgical procedures.
•     Physician can have consultation or courtesy privileges at a hospital but no admitting privileges
•     Coverage is free of cost but they do have to go through the underwriting process
•     Physicians actively insured with COPIC who would like to provide volunteer services should contact their COPIC underwriter for details

Each year, COPIC provides liability coverage for more than 75 Colorado and Nebraska physicians who qualify and deliver invaluable patient care. If you would like to find out more about the volunteer physician coverage and determine if you are eligible, please contact Sales at 720.858.6186 or sales@copic.com.

New Senate report on primary care access

"A new Senate report, Primary Care Access outlines the critical shortage of primary care providers across the nation and predicts a growing primary care shortage. The report urges increased investment in the primary care workforce and in community health centers. Tess Stack Kuenning, executive director of Bi-State Primary Care Association, was among those who testified at a Senate hearing on the need for primary care."  [Source: Association of Clinicians for the Underserved]

HCPF Newsletters (CHP+ and "On the Horizon") and upcoming CICP Stakeholder Forum

The February 2012 issue of the newly titled, "On the Horizon" CHP+ Newsletter features the following:

• Frontline , Children’s Buy-In Update & AwDC Update
• Adult Buy-In Update & 2013 FPLs
• Timeliness Corner & Did You Know?
• Medical Services Board
• Resources
• Work Group Update & Contact Information

The  February 2013 Provider Bulletin is also available.  This bulletin contains information about Medicaid Expansion in 2014; OAP Provider Rate Increase; EHR Incentive Program; Healthy Living Initiatives and more.

Finally,  the Colorado Department of Health Care Policy and Financing is holding a CICP Stakeholder Forum on February 21, 2013 9:00 am to 12:00 pm.  Click here to view the agenda. Please RSVP to Karen Talley.

NURSE Corps Loan Repayment Program 2013 Application Cycle Open!

The 2013 application cycle is now open for the NURSE Corps Loan Repayment Program! The deadline to apply is February 28, 2013, at 7:30 pm EST. Click here to learn more about program eligibility and requirements and click here to begin your application.

February 9th: Intensive Diabetes Management for Primary Care

When: Saturday, February 9, 2013
Where: Hyatt Regency 650 15th Street, Denver, CO 80202
Cost: $75
Click to register (Registration Closes February 9th)

An  upcoming professional conference, "Intensive Diabetes Management for Primary Care," is being offered by the American Diabetes Association Colorado, Wyoming & Montana.  It has been designed specifically for physicians, pharmacists, dietitians, certified diabetes educators and other health care professionals who care for patients with diabetes and who manage the complications related to this disease.  You will learn to identify technological advancements in diabetes care to improve glycemic control, describe current treatment options for patients with diabetes, including how to incorporate new agents, and more.   Certificates of Completion/Attendance are provided to registered attendees based upon completion of the online evaluation that will be available online.  Click here to learn see the conference flyer.    [Source: COPrevent]

HCPF Provider Bulletin

Click here to read the January Provider bulletin. The index includes:

All Providers .........................................1
Web Portal Upgrades.............................1
Clarification of Blood Lead Testing for Medicaid-Eligible Children......................2
2013 HCPCS Codes Update..................2
Primary Care Provider Supplemental Payments ...............................................2
Tax Season and 1099s ..........................3
January and February 2013 Holidays ....3
Dental Providers...................................3
Dental PARs...........................................3
Home Health Providers........................5
Appendix N Update ................................5
Hospital Providers................................5
OP Hospital Supplemental Medicaid Payment .................................................5
Practitioners .........................................5
Office Administered Drugs, Lupron Depot....5
Pharmacy Providers.............................6
IHS Pharmacies Billing Updates ............6
Benefit Updates for Benzodiazepines and Barbiturates ............................................7
Updated Pharmacy Reimbursement Methodology...........................................7
Total Prescription Volume Surveys ........7
January and February 2013 Provider Workshops............................................7
Attachment A - Percentage Adjustment Factors.........................................................A-1

[Source: Colorado Department of Health Care Policy and Financing]

HCPF Provider Bulletin

Click here to read the December Provider bulletin. The index includes:

All Providers .................1
ColoradoPAR Program.............1
Second Phase Update of NCCI Implementation.................3
‘Meaningful Use’ Submissions from Health Care Providers Using EHR.........3
Add-A-Baby Project..................4
CHP+ Income Eligibility Policy Changes for Pregnant Women ..........4

Updates from HCPF

Colorado Department of Health Care Policy and Financing has released the following:

• CICP November newsletter is now available.
• Annual Report to the Joint Budget Committee on the Accountable Care Program  
• Click here to read the November Provider bulletin.

Report: Issues and Policy Options in Sustaining a Safety Net Infrastructure to Meet the Health Care Needs of Vulnerable Populations

"As a result of coverage expansions under the ACA, the mix of reimbursement to health care providers will change. While safety net providers are expected to remain an important source of care for vulnerable populations, including the newly insured, the ramifications of changes in the amount and mix of insurance coverage remain unclear. This report, the third in a series that reflects the work of the National Workgroup on integrating a Safety Net into Health Care Reform Implementation, addresses the workforce and financing infrastructure needed to support a sustainable safety net to serve vulnerable populations."  Read the full report.  [Source: NASHP]

HCPF Provider Bulletin

Click here to read the September Provider Bulletin. The index includes:

All Providers .........................................1
Proof of Eligibility Letter..........................1
Safeguarding Medical Identity Toolkit ....1
Colorado Choice Transition....................2
Fee Schedule .........................................2
PAR Submission to the ColoradoPAR Program..................................................2
Client Over-Utilization Program (COUP).... 3
ACC Program Referral Requirement......4
ACC Payment Reform Initiative..............4
Dual Eligibles..........................................4
Record Retention....................................5
September & October Holidays..............5
Dental and Orthodontic Providers......5
PAR Procedures Update ........................5
DME/Supply Providers.........................6
Special PAR Submission Requirements.... 6

...and much more!

HCPF Provider Bulletin

Click here to read the July Provider bulletin. The index includes:

In this issue:
All Providers ........................................ 1
PAR Submission.................................... 1
Nurse Advice Line ................................. 2
Implementing the SPA for TCM............. 2
Independence Day Holiday ................... 2
Ambulatory Surgical Centers (ASCs) 3
Billing Reminder .................................... 3
Dental and Orthodontic Providers..... 3
PAR Submission.................................... 3
Dialysis Providers ............................... 3
Billing Reminder .................................... 3
DME Providers..................................... 3
AACDs, Electrical Stimulation Devices, & Apnea Monitors Benefit Coverage Standards3
Emergency & Non-Emergency Medical Transportation Providers.................... 3
1% Rate Reduction - Effective July 2012 .....3
Home Health Providers....................... 4
PAR Submission.................................... 4
Practitioners......................................... 4
Using CPT Code 11981......................... 4
School-Based Health Center (SBHC) Providers .............................................. 4
Benefit Coverage Standard ................... 4
Therapy Providers............................... 4
Combined 48 Unit Limit Postponed....... 4
Vision Providers .................................. 5
Coverage of Vision Therapy.................. 5
Pharmacy Providers............................ 6
Next DUR Board Meeting...................... 6
Prior Authorization Updates................... 6
COBManager Process for Pharmacy Claims 6
PDL Update ........................................... 6
Next P&T Committee Meeting............... 7
July and August 2012 Provider Workshops......................................................... 7
Transportation Rates & PAR Requirements..................Attachment A

AMA Offers Online Tutorial to Help with Health IT

"The American Medical Association plans to launch several Web-based tutorials to help physicians integrate health information technology into their practices.

The tutorials offered are: e-prescribing, pre-visit planning, and point-of-care documentation. Each of the tutorials focuses on understanding workflow and what changes to expect with new technologies.

To read the entire article, click here."  (Source: Colorado Rural Health Center)

Bundled Payments Webinar: Resources and Legal Considerations for Colorado Providers

As part of CIVHC's efforts to enable coordinated health care delivery approaches that reward value rather than volume, CIVHC is pleased to invite you to a unique opportunity to deepen your understanding of how to implemented bundled payments for health care services. 

WHAT: Bundled Payments - Resources and Legal Considerations for Colorado Providers

WHEN: July 17th, 12:30-2:00 pm MT

WHO SHOULD ATTEND: Hospital administrators, physicians, physician practice managers, health plan executives.

Registration is free.  Click here to learn more about this opportunity and to register.

HCPF Provider Bulletin

Click here to read the June Provider bulletin. The index includes:
 

All Providers ........................................ 1

PAR Submission.................................... 1
ACC Providers....................................... 2
Colorado Choice Transitions (CCT) Program................................................. 2
Immunization Services Billing Manual .....2
Non Payment for Provider Preventable Conditions.............................................. 3
RAC Program Update............................ 4
Provider Status Verification ................... 4
Independence Day Holiday ................... 4
CHP+ Providers ................................... 5
Copay Changes..................................... 5
Dental & Orthodontic Providers......... 5
PAR Submission.................................... 5
DME & Supply Providers .................... 5
Revised Billing Manual .......................... 5
Home Health......................................... 5
Home Health PARs ............................... 5
Hospice Providers............................... 5
Prognosis Required for Hospice............ 5
PT, OT, S-L & Hearing Providers ....... 6
Benefit Coverage Standards ................. 6
Changes for Outpatient PT and OT Benefit ................................................... 6
Skilled Nursing Facility Providers ..... 6
New PAR Vendor in July 2012 .............. 6
Surgery Providers ............................... 7
Bariatric Surgery and Intersex Surgery Benefit Coverage Standards ................. 7
Pharmacy Providers............................ 7
PDL Update ........................................... 7
PDL News.............................................. 7
Next P&T Meeting ................................. 8
June & July 2012 Workshops............. 8

Colorado Medicaid Workshops

ACS is offering Web-EX presentations of basic billing for the CO1500 and the UB04 providers.  These Web-EX workshops are set up specifically for the providers servicing Medicaid clients outside the Front Range geographical area. In a time when practices need to run “lean and mean”, it may be good to know there is no enrollment fee for providers to dial into these sessions.

For more information on these Web-EX trainings please click here.

ICD-10 Webinar

September 20, 2011; 12-3pm

Register now for a webinar offered by the Colorado Rural Health Center, covering ICD-10, documentation, billing and coding updates, as well as identify practical ways to be proactively prepared for the future.  All health care providers, particularly physicians are invited to attend.

Click here for more information and to register.

HCPF Provider Bulletin

Click here to read HCPF's latest Provider Bulletin.