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

• SIM releases third and final application for cohort 3
• Medicaid Primary Care Payment Reform - read the survival guide & complete the APM Measure Selection Survey!

Colorado interChange: Resources for your Membership Week of November 16, 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: You may have been hearing a lot about "the Bridge" from case managers. The Bridge is a system used by case managers for Home and Community Based Services (HCBS) to submit Prior Authorization Requests (PARs)-- the Bridge is not used for medical PARs. Only after a PAR is approved is it transmitted to the Colorado interChange for processing. It takes at least one day, after the PAR is approved in the Bridge, to appear in the Colorado interChange and be available for claims processing.  In early October, the Department made initial awards for seven Regional Accountable Entities (RAEs) for the next iteration of the Accountable Care Collaborative (ACC). Following those awards the Department received formal protests. In accordance with State procurement rules, the Department is prohibited from discussing the solicitation, contract awards and negotiations until all protests and appeals are resolved. The Department is continuing to prepare for the implementation of the next phase of the ACC as these protest are resolved. Read more about implementation goals and timeline. If Congress fails to act on funding for the Children's Health Insurance Program, or Child Health Plan Plus (CHP+) in Colorado, the program will end on January 31, 2018. Prior to that, families using the program will begin receiving information about the potential program end in late November. As of today, there are no changes to CHP+ benefits and providers are urged to keep serving CHP+ members at their practices. Even if Congress does not act to renew CHP+ funding, enrollment and redetermination of CHP+ members will continue through the planned program end on January 31, 2018. Resources are available to help providers communicate with their CHP+ patients about the status of the program.

News You Can Use

Here's some content for membership newsletters: New help for provider revalidation and enrollment   Providers still struggling with revalidation or enrollment-- the first step to successfully using the Colorado interChange for claims -- can get additional help with issues they face. The Colorado Department of Health Care Policy and Financing recently released a new webinar aimed at answering common questions and issues with the process. The hour-long webinar tackles topics like revalidation documentation, web portal registration, best practices as well as solutions for the top five reasons revalidation and enrollment will deny. Following the webinar, participants were able to ask questions.

Colorado interChange Numbers

Since March 1, 2017... More than $5.5 billion paid to providers 35.6 million claims have been processed  In our latest financial cycle on Friday, Nov. 10 ... $130 million paid to providers 953,345 claims processed As a reminder, the Department frequently updates its Known Issues & Updates web page with new issues, work arounds and resolution ETA.

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

CCHAP Practice Manager Newsletter - November 8, 2017
SIM Health Elevations - November 2017
At a Glance - October 2017
Accountable Care Collaborative Phase II Update - November 2, 2017

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

11/14 Update from the Colorado Health Policy Coalition:

"In late October Congressional Republicans turned their attention away from health care "repeal and replace" and "stabilization" to focus on tax policy. It looks, however, like health care is now taking center-stage in the tax reform debate as well. 

Today, Senate Republicans announced plans to include a provision to repeal the individual mandate for coverage in their tax reform plan. Not only does this serve to undermine the stability of the Affordable Care Act, but it also helps to pay for tax cuts proposed in the package. The Congressional Budget Office has estimated that repealing the mandate will reduce federal spending by $338 billion over 10 years and reduce the number of insured Americans by 13 million. 

In response, a coalition of six major physician, hospital and insurer groups sent a letter to Congressional leadership opposing the proposal and outlining the critical role the mandate plays in stabilizing the marketplace. Families USA, a leading consumer advocacy organization, also released a statement of opposition." 

11/14 Update from the Protect Our Care Colorado Coalition:

"Stop the GOP Tax Bill That Will Devastate Health Care!

The House GOP is planning to vote this week on a tax bill that will devastate health care! The GOP tax heist cuts taxes for the wealthiest 1% and big multinational corporations, increases taxes on some middle-class families, and adds $1.5 trillion to the deficit over 10 years. While it's not in the tax bill itself, we know from the GOP budget that they plan to pay for this increase in deficit by gutting Medicaid by nearly $1 trillion, Medicare by over $400 billion, and slashing other programs that hard-working American families rely on. This tax heist:

• Will lead to even more disastrous cuts to health care than we've seen in the devastating Republican health care repeal bills that failed due to enormous public pressure.
• Will disproportionately benefit millionaires and large profitable corporations, not small businesses or the middle-class.
  • 80% of the tax cuts go to the top 1% and big corporations
• Will devastate Colorado's state budget and lead to cuts in state programs and services that help families get by and get ahead.

For more detail on how the tax plan affects different populations, the Center on Budget and Policy Priorities has a variety of summaries and resources or you can read this summary from the Tax Policy Center.

Call your Representative now and tell them to oppose this tax plan that will harm Colorado families!

Rep. Coffman - Aurora (720) 748-7514, DC: (202) 225-7882

Rep. Tipton - Durango: (970) 259-1490, DC: (202) 225-4761

Rep. Buck - Greeley: (970) 702-2136, DC: (202) 225-4676

Rep. Lamborn - CO Sprngs: (719) 520-0055, DC: (202) 225-4422

Rep. Polis: Boulder - (303) 484-9596, DC: (202) 225-2161

Rep. Perlmutter - Lakewood: (303)274-7944 DC: (202) 225-2645

Rep. DeGette - Denver: (303) 844-4988, DC: (202) 225-4431

Call your Senators:

Sen. Gardner-Denver: (303) 391-5777 DC:(202) 224-5941

Sen. Bennet-Denver: (303) 455-7600 DC:(202) 224- 5852

Social Media: We are using the hashtags #TrumpTaxScam, #GOPTaxPlan, and  #NotOnePenny to talk about the tax bill.

• @RepMikeCoffman You've said time and again that you are concerned about the deficit. Vote no on #TrumpTaxScam! Don't add $1.5 trillion to deficit. #NotOnePenny
• @RepMikeCoffman Please oppose the #GOPTaxPlan that will increase deficit, give tax cuts to top 1%, and lead to devastating health care cuts.
• @RepTipton Don't increase the deficit, give 80% of tax cuts to top 1%, or gut Medicaid/Medicare to pay for it. #VoteNo on #GOPTaxPlan. 
• Don't saddle future generations with another $1.5 trillion in debt from #TrumpTaxScam @RepTipton. And don't use cuts to Medicaid or Medicare as a piggy bank for the wealthiest 1%.
• @RepKenBuck Don't vote for a #GOPTaxPlan that increases the deficit, gives tax cuts to top 1% on the backs of middle-class, or will lead to devastating health care cuts. #NotOnePenny."

#FundCHIPColorado

11/6 Update from the Colorado CHIP Coalition:

"Policy Update from DC:

The House bill to extend funding for CHIP and other health programs that included concerning cuts to Medicaid, Medicare and the Prevention and Public Health Fund passed out of the House on Friday morning along a largely party-line vote, though 3 Republicans voted against the bill and 15 Democrats voted for it. The Georgetown Center for Children and Families summarized the latest developments here: https://ccf.georgetown.edu/2017/11/03/house-votes-to-extend-chip-funding-without-bipartisan-agreement-on-payfors/. It remains unclear what will happen next and whether or not the Senate will take up the House bill. Because the offsets in the House bill are not bipartisan, we are hearing that it is unlikely that progress will be made on CHIP until December.

Updated HCPF Website:

The Department of Health Care Policy and Financing has updated their website about the future of the CHP+ program in Colorado and the site now has information for families, providers and advocates. They have also posted a copy of a communication that will go out to CHIP families in late November."

Creating Safer Spaces for Immigrant Patients webinar

Upcoming webinar with the National Immigration Law Center: 

Creating Safer Spaces for Immigrant Patients

Wed, Nov 8, 2017 11:30 AM - 1:00 PM PST

This webinar is intended for healthcare providers.

Description: This webinar will provide an overview of various safe space policies that have been created at clinics, hospitals, and community health centers, focusing on: the types of procedures created; the factors considered when creating the procedures; the internal advocacy steps it took to get there (example: to convince managing staff to take action); lessons learned from implementation; and future plans of action.

Register at: https://register.gotowebinar.com/register/5819945230064272899

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

At a Glance - October 2017
Accountable Care Collaborative Phase II Update - November 2, 2017
SIM Health Innovations - October 2017

Colorado interChange: Resources for your Membership Week of November 2, 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: New Quick Guides are in development to continue to provide resources for providers as they work to navigate the Colorado interChange implementation. The first of these, Revalidation and Enrollment Quick Guide, has joined others already published. Providers should use this Quick Guide if they are beginning a revalidation application or are having difficulties with the process. The Department is hosting a Revalidation and Enrollment Webinar, tomorrow, November 3, 2017. For more information, see the invitation sent to providers.  Providers and others have asked how the Department understands the process for achieving normal operations for the Colorado interChange. The Department has always seen that effort as a multi-step process that would include continuous improvements and fixes to the system through the first six to nine months of operation. You can read more in the recent Implementation Update sent to providers. The Department understands that the Provider Services Call Center continues to be an area of frustration for providers and is working to improve training for agents and increase the available resources to reach the goal of "one call resolution." While call wait times have dropped to an average of 60 seconds, there is still work to do on the quality of the calls and their ability to resolve provider issues quickly. Current improvements include:   Onboarding a call center supervisor with extensive call center experience Additional staff hired to perform call quality control reviews Department staff in the call center to help give callers real-time quality answers Department program managers will train call center staff on program basics

News You Can Use

Here's some content for membership newsletters: Child Health Plan Plus Update As you may know, Congress has not reauthorized federal funding for the Children's Health Insurance Program, known as Child Health Plan Plus (CHP+) in Colorado. Unless Congress acts to restore federal funding, CHP+ in Colorado will end January 31, 2018. The Colorado Department of Health Care Policy and Financing has resources to help you answer questions from CHP+ applicants and members. The Department will update this page regularly and post a recorded webinar in late November to further assist you if Congress has not acted to fund the program.

Colorado interChange Numbers

Since March 1, 2017... More than $5 billion paid to providers 34 million claims have been processed  In our latest financial cycle on Friday, October 27... $107.3 million paid to providers 1,009,193 claims processed As a reminder, the Department frequently updates its Known Issues & Updates web page with new issues, work arounds and resolution ETA.

To sign up for this email list, click here.

#FundCHIPColorado

The House is expected to vote on CHIP this week.

While we are happy to see funding for the critical health insurance program for nearly 9 million kids and pregnant women advance, the current plans calls for funding the Children’s Health Insurance Program by making cuts to Medicaid and the Prevention and Public Health Fund. The Prevention and Public Health funding is critical to our state – the proposal would cut tens of millions of dollars from public health programs in Colorado. This funding supports lead poisoning prevention, smoking cessation and breastfeeding support in our communities.

We need to tell Congress that healthy kids shouldn’t come at the expense of healthy communities.

Some states are already shutting down their CHIP programs. Colorado’s nearly 90,000 CHIP kids and pregnant women will lose their insurance coverage in Jan. 2018. But there’s still time for Congress to do the right thing. Call your Representative and let them know you expect them to keep kids and our communities healthy.

Contact Information for Colorado’s U.S. Representatives

Representative Coffman

Call if you live in Aurora, Centennial, Highlands Ranch, Brighton

Local office (720) 748-7514 National office (202) 225-7882

Representative Tipton

Call if you live in Grand Junction, Durango, Pueblo, Gunnison

Local office (970) 259-1490 National office (202) 225-4761

Representative Buck

Call if you live in Greeley, Fort Collins, Longmont, Brush, Burlington, Fort Morgan, Stratton, Julesburg, Holyoke

Local office (970) 702-2136 National office (202) 225-4676

Representative Lamborn

Call if you live in Salida, Buena Vista, Colorado Springs, Monument, Fountain, Canyon City, Woodland Park

Local office (719) 520-0055 National office (202) 225-4422

Representative Polis

Call if you live in Lafayette, Niwot, Boulder, Fort Collins, Lyons, Loveland, Granby, Breckenridge, Silverthorne, Kremmling  

Local office (303) 484-9596 National office (202) 225-2161

Representative Perlmutter

Call if you live in Lakewood, Arvada, Westminster, Thornton, Northglenn

Local office (303)274-7944 National office (202) 225-2645

Representative DeGette

Call if you live in Denver

Local (303) 844-4988 (202) 225-4431