News for Case Managers

NEW SCHEDULE REVISIONS: Case Management Redesign (CMRD) Rule Revision Stakeholder Feedback Meeting Series

Based on the flow and progress of the meetings held so far, the Department has made further changes to the CMRD Rule Revision stakeholder meeting series. These changes are listed below and posted on the OCL Stakeholder Engagement Calendar.

These meetings have been canceled. Please remove these dates from your personal calendar:

• Tuesday, Jan. 31, 2023
• Tuesday, Feb. 14, 2023
• Tuesday, Feb. 28, 2023
• Tuesday, March 14, 2023

These meeting dates and topics have been updated:

• Tuesday, March 28, 2023, 9 – 11 a.m. MT: Case Management Agency Requirements
• Tuesday, April 11, 2023, 9 – 11 a.m. MT: Case Management Agency Requirements/Case Manager Requirements and Functions
• Tuesday, April 25, 2023, 9 – 11 a.m. MT: Case Manager Requirements and Functions
• Tuesday, May 2, 2023, 9-11 a.m. MT: HCBS Benefits and services rules part 1
• Tuesday, May 16, 2023, 9-11 a.m. MT: HCBS Benefits and services rules part 2
• Tuesday, May 30, 2023, 9-11 a.m. MT: HCBS Benefits and services rules part 3
• Tuesday, June 13, 2023, 9-11 a.m. MT: HCBS Provider Requirement rules
• Tuesday, June 27, 2023, 9-11 a.m. MT: Wrap up and next steps

The meeting access information remains the same for all CMRD meetings:

Join via Zoom

Meeting ID: 873 9014 4539, Passcode: 597847

Join via Phone:

Toll-free: 1-877 853 5257

Background

The Department will update rules and regulations pertaining to HCBS waivers and non-waiver programs to come into alignment with the new CMRD statute, policy and language. Rule updates are required to clean up areas in existing rules and waivers that are repetitious, obsolete, or difficult to follow and understand. CMRD also implements changes to the rule structure. The vision behind the structure change is to make the Home and Community-Based Services (HCBS) rules easier to find, read and understand for all stakeholders. Rules must be in effect no later than Nov. 1, 2023, at which point the first cohort of new Case Management Agencies under CMRD will transition.

The Department wants to hear from stakeholders about each of the rule revision topics listed below to ask questions and receive feedback based on your knowledge and experience with navigating HCBS rules. The goal is to make these rule revisions work for all HCBS stakeholders. The Department will post the section of rule or waiver to be discussed on the CMRD webpage one week prior to each meeting. Stakeholder engagement, feedback, and Department responses will be tracked through listening logs posted on the CMRD webpage.

New HCBS Utilization Review/Utilization Management Webpage 

HCPF is excited to share a new webpage dedicated to HCBS Utilization Review/Utilization Management. This webpage will be the landing page for resources related to Children's Extensive Supports, Children's Home and Community-Based Services, Health Maintenance Activities, Over Cost Containment, and Supported Living Services reviews conducted by Telligen. This webpage will be replacing the resources on the LTSS training webpage. Case Managers can find information regarding upcoming Telligen Office Hours, Telligen Tip Sheets, Procedure Code Modifier list and more.

BUS Member Record Search and Duplicate Record Creation

Before creating new member records in the Benefits Utilization System (BUS), case managers must verify that there are no existing member records by searching for members using each of the criteria below:

• Last Name
• Date of Birth
• Medicaid ID
• SSN

Why is this so important?

If a member record is flagged as a duplicate, that member’s record will not migrate to the new CCM system. The CCM system will accept the most recently created record and its associated data (Log notes, Critical Incidents, Assessments and Service Plans). The original record will not migrate, and all the data contained in that record will not be available in the CCM.

How to ensure all data is migrated from the BUS to the CCM

If a case manager realizes they have created a duplicate, they must submit a BUS Tracker so the records can be merged. Labeling the record as “DO NOT USE” will cause issues with the member's record.

Each week until the CCM System Go Live, Rhonda Johnson will be emailing each case management agency to advise the agency of their duplicates. 

Case managers may contact Rhonda at Rhondab.Johnson@state.co.us with questions about this process.

Deadline for 3rd Party New User Access Forms

The last day for new user 3rd Party Access forms will be Jan. 31, 2023. The Department will no longer accept new 3rd Party User Access forms for the Benefits Utilization System (BUS) and DDDWeb on Feb. 1, 2023.  

This is to ensure appropriate time for new user provisioning and time for Department Security to start processing access forms for the CCM system.  

The Department will still accept Revocation forms for users leaving the agency, Reinstatement forms for users who have not logged into the system for 90 days or more, and Modification forms for users needing their access level updated.

Bridge access forms will not be affected, and the Department will still accept all 3rd party user access forms for the Bridge.

New 3rd Party User forms for CCM access will be sent out to the agencies on Jan. 30, 2023. This will be a new streamlined form utilizing AdobeSign. The deadline to have the forms returned to the Department will be Feb. 15, 2023.