Monday, January 29, 2018

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 16th, 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:

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!

#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:
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."

Friday, January 19, 2018

Government Shutdown Imminent!

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

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:

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

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)

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: