September 2023

Case Manager's Corner

Care and Case Management (CCM) System News

CCM System Fixes

HCPF would like to thank case managers for their partnership and patience as our vendor continues to apply fixes and improvements to the new Care and Case Management (CCM) system. Below are updates to two issues.

Resolution to Care Plans and Service Plans which did not Automatically Generate

On Sept. 15, AssureCare ran a script in the CCM to generate Care Plans and/or Service Plans for members for whom they did not previously automatically generate.

Once HCPF has confirmed the fix, we will contact the users who submitted support requests. Case managers may also verify whether this has been resolved for members on their caseloads.

If successful, the next steps are to complete the Care Plans and/or Service Plans that have been generated.  

If only the Service Plan was needed, verify that the Care Plan issues and goals section has been completed and, even if there are no changes needed, select "edit" and "save." This should trigger the goal interface with the Bridge. 

HCPF has noticed some members seem to have duplicate Service Plans. If you see this for your member(s), please proceed with completing one of them. CMA Administrators can void duplicate Service Plans if needed.  

If a support request was submitted for a member for this issue and you are able to confirm that the fix was successful before HCPF confirms and notifies you, please notify the support team. In your message, include the member(s) ID, whether the script was successful for the member(s), and if there are duplicates. This will help us prioritize validation for other members, and resolve requests. 

If the member's issue with Care Plans and/or Service Plans has been resolved by this fix, but an issue with the PPA remains, please submit a support request for the PPA issue. This will help us to track those outstanding issues and improve the script for the future.  

Assessment/Support Plans Screen

Comment fields in the LTC Level of Care Eligibility Assessment (Legacy ULTC 100.2) are difficult for users to read due to text field format. 

Users may have difficulty reading content entered in the Comments fields in the Activities of Daily Living & Level of Care Determination within the LTC Level of Care Eligibility Assessment (Legacy ULTC 100.2) due to fields being formatted as text fields instead of text boxes. 

Interim Solution: Users may generate a “Legacy 100.2 Assessment Printout” document to view the Comments content in a readable format. Click on the “Page Resources” drop-down triangle at the top right of the page, click the “+” button next to Documents tile, then click on the “Merge & Send” button. When a new screen opens click on “Mail” for the Legacy 100.2 Assessment Printout. Click “Next” on the Merge & Send screen. Click “Send” and the document will appear on the Documents tile. Click on the “View” button. To read comments, navigate to the appropriate section of the file using the arrows at the bottom of the screen. 

Training Resources

  • Recordings Folder Updated - Shorter topic-specific videos of demos are now live in the Google Drive 
  • Updated Job Aids (Sept. 6, 2023) 
  • CCM System Job Aid Glossary  
  • HCBS Initial Enrollment, CSR, and Service Planning Checklist  
  • Legacy 100.2  
  • Program Card Job Aid on hold - Known Issue Program Card direction is forthcoming.  

CMA SuperUser workgroup 

  • The initial meeting was held on September 18
  • Provide direct feedback on Phase 1 training 
  • Help to identify current and future training material needs 

Other News

Interested in Participating in a Self-Direction Evaluation Study? 

HCPF is partnering with Mission Analytics to learn more about self-directed services. Together, we plan to identify the optimal self-direction authority for respite, non-medical transportation, and home modification, acupuncture, chiropractic, and massage (on the Complementary and Integrative Health Waiver). As an evaluation study, the focus is to understand the best authority, and does not include regulatory changes or implementation. If you are interested in learning more and engaging on this topic, please fill out this form by Oct. 16. Contact Corinna Barrack with any questions. 

Telligen Office Hours 

Telligen is hosting office hours for case managers to answer questions regarding Utilization Review Utilization Management (URUM) reviews for: 

  • Health Maintenance Activities 
  • Over Cost Containment 
  • Supported Living Services (SLS) Exception 
  • Children's Home and Community-Based Services (CHCBS) 
  • Children's Extensive Services (CES) 

Please submit any office hours topic requests by using the Telligen Support Request form no later than Nov. 9, 2023.  

Meeting Details 

9:30 - 11 a.m. 

Nov. 16, 2023  

Please register to join.   

Each attendee should register individually. Questions and answers from previous office hours are on our webpage under Telligen Office Hours. 

Learning Collaborative Series for Colorado HCBS Case Managers

As we navigate change and opportunity in the Colorado Home and Community-Based Services (HCBS) system, including Case Management Redesign, this monthly series of 50-minute discussions aim to provide individual Colorado HCBS case managers the opportunity to consider new strategies, gain knowledge, and enhance strengths – especially during times of transition. Each session will offer a live presentation, attendee activities, group discussions, and time for questions and answers regarding the monthly topic. 

Join us for our next session: 

Meditation: Developing Mindfulness for Case Managers 

11-11:50 p.m.

Thursday, Oct. 12, 2023 

Register and join on Zoom or join by phone: 1-877-853-5257 

Meeting ID 959 2645 1605, Passcode 571090  

In this interactive presentation, participants will learn basic meditation and mindfulness skills to support self-care, health, and wellness. With these skills, case managers can learn to practice mindfulness and meditation in their personal and work lives. 

To learn more about case management redesign, visit the Case Management Redesign webpage.

Organized Health Care Delivery System (OHCDS) and Home Modifications for Supported Living Services (SLS) and Children’s Extensive Supports (CES) Waivers 

This is a reminder to all Case Management Agencies (CMAs) that there are upcoming changes to Home Modifications that are using OHCDS as a delivery model. 

  • Effected November 1, 2023 OHCDS will no longer have the Home Modification benefit as a delivery model.
  • This will be for all Home Modification projects regardless of cost.
  • Any projects using OHCDS as the delivery model will need to have billing completed by October 31, 2023.

If any CMA has a non-Medicaid contractor that may be interested in becoming a Medicaid contractor please reach out to Emily Walsh.

Covid-19 Public Health Emergency Unwind 

Colorado is resuming regular eligibility reviews for people with Health First Colorado (Colorado's Medicaid program) and Child Health Plan Plus (CHP+) after a 2+ year pause during the COVID-19 public health emergency (PHE).

Temporary extension for all members up for renewal in September/Early October

HCPF received new guidance from the Centers for Medicare and Medicaid Services (CMS) on Aug. 30, 2023, that requires a change to the ex parte process for renewals.

Instead of renewing members through ex parte (automation) at the household level (all members of a household receiving Health First Colorado or CHP+ benefits reviewed for eligibility at the same time), as has been done in the past, CMS is now requiring states to perform ex parte automation reviews on an individual basis, meaning each person in the household is reviewed and approved separately.

Today, the system moves households where everyone in the family can’t be approved through an automated ex parte process into the renewal eligibility completion and submission process. This new CMS guidance will require significant changes to our eligibility system that will need to be completed in a phased approach.

As a result, HCPF is implementing a temporary renewal extension for all members up for renewal in September and October until we implement a short-term system change in mid-October to bring us into compliance with the new CMS ex parte guidance.

HCPF is also developing a strategy to renew coverage for members who were disenrolled if a household did not properly complete and submit the required renewal application. HCPF will communicate the strategy once it is final. Members eligible to have their coverage renewed will be notified.

Ongoing 60-day renewal extension for vulnerable populations

HCPF is leveraging additional flexibility from CMS to provide a 60-calendar-day extension to complete the renewal process for our vulnerable populations, including long-term care (LTC), members on waivered services, and buy-in recipients who have not returned their renewal packet on time during COVID unwind.

This extension also allows HCPF to do additional outreach to these vulnerable members when they are up for renewal, while providing extra time for the members to return the information and the counties to process it.

The extension is in effect Sept. 5 through the remainder of the unwind period, June 2024. It does not affect members who have already submitted their renewal packet to the county or those who have completed the renewal process.

If a member has already turned in their renewal packet and still needs to submit additional information, the county may grant additional time through a Good Faith Extension for a member to turn in this information. 

Frequently Asked Questions

Can members with long-term care (LTC) have more time to complete the renewal process?

Yes, HCPF is leveraging guidance from CMS to extend the renewal period for people with LTC, waivered services and disabled buy-in members who have not returned their renewal packet or members who returned their renewal packet but its review has not been started by an eligibility site.

Instead of the 30-day delay CMS recommended, Colorado will be extending the renewal time frame for LTC members by 60 calendar days to allow for additional outreach and action on the renewal. This allows LTC members to have an additional 60 calendar days to return their packet or for it to be processed by the county for cases that are past due.

Do LTC members still need to complete, sign and return their renewal packets if a special extension is issued?

Yes, all members must complete, sign, and return their renewal packet to continue coverage, and they are encouraged to do so right away when it is their time to renew.

Special extensions allow extra time for more complex renewals; however, members may still risk losing coverage if renewals are not completed during the extended timeframe. Members must take action to maintain their coverage by submitting all the required information and documents.

How is Colorado responding to new guidance from the Centers for Medicare and Medicaid Services (CMS) for the ex parte process?

All states received guidance from CMS on Aug. 30, 2023, that requires a change to the ex parte (automation) process for renewals.

Instead of renewing members with ex parte at the household level (all members of a household receiving Health First Colorado or CHP+ benefits reviewed for eligibility at the same time), as has been done in the past, CMS is requiring states to perform ex parte automation reviews on an individual basis, meaning each person in the household is reviewed and approved separately.

While this will increase automation and efficiencies over the long term, this new guidance will require significant changes to our eligibility system that will need to be completed through a phased approach. As a result, HCPF is implementing a temporary renewal extension for all members up for renewal in September and October until we implement a short-term system change in mid October to bring us into compliance with CMS guidance. The extension and short-term system change will not impact the member’s experience of the renewal process. Members are strongly encouraged to complete, sign, and return their renewal packet right away.


If a member with a September 2023 renewal date misses the deadline, will they lose coverage on Sept. 30?

Members with a September renewal have until mid-October to return their packet without losing coverage while we implement a short-term fix for the ex parte process. If a member is determined to no longer be eligible for coverage during their renewal cycle, their coverage may end at the end of October. Members are strongly encouraged to complete, sign and return their renewal packet right away, not wait until the last minute.

What is the good faith extension?

The Good Faith Extension is an agreement between the HCPF and counties to support all members going through the renewal process who indicate they are attempting to gather requested verifications and experiencing challenges and/or need additional time to gather documentation. County eligibility workers can use this extension to support members in taking additional time to submit the verifications and avoid an unnecessary termination.

Can a member return their renewal packet late?

Members can resume medical coverage if they still qualify by returning their renewal packet and any missing information to their county for processing within 90 days of losing coverage. In PEAK, an item was added to the To-Do List to indicate when a late medical assistance renewal can be submitted and processed without needing a new application. Members are encouraged to return renewal packets within 90 days if they miss the deadline rather than submitting new applications.  

Can a member’s eligibility be backdated if they are disenrolled?

If a member is disenrolled for a procedural reason, they have a 90-day reconsideration period to submit their renewal packet. If they are determined to still be eligible during that 90-day period, coverage begins as of the 1st of the month they are determined eligible again.

If there is a gap in coverage, members must ask the county to be enrolled retroactively. If a member is determined no longer eligible, and they disagree with the decision, they can file an appeal. 

How can you help support members during the PHE unwind?

HCPF has developed extensive partner toolkits regarding the end of the continuous coverage requirement. Update Your Address, Understanding the Renewal Process and Take Action on Your Renewal toolkits all include resources to help members take action to keep their coverage. A new joint webpage includes partner resources and information for those who may need to transition to other health coverage. Flyers have recently been developed for Colorado employers to distribute to their employees to help spread the word.  

You can help us raise member awareness about the renewal process by sharing the messaging in our toolkits. 

The materials in the toolkits identify key actions for members to take: updating contact information, taking action when a renewal is due, and seeking help with renewals at community or county resources when they need it. Flyers, social media messaging and graphics, website content, and other outreach tools can be found in our PHE Resource Center. Partners can also educate themselves and their staff on the basics of the renewal process to assist members who may need help. See our Renewal Education toolkit

Members with questions about the renewal process can learn more by visiting Health First Colorado’s renewal webpage available in English and Spanish

A special thank you for your partnership and continued collaboration!

More Frequently Asked Questions (FAQs) about the end of the continuous coverage requirement and return to regular renewal processes have recently been added and are available in the PHE Planning Resource Center.  

County Complaints

If a Health First Colorado or CHP+ member or applicant has a problem or feedback about their eligibility renewal, they should first contact their local county to attempt to resolve the situation. Working with their county is the most direct way to address an issue and may result in a quicker resolution. If an issue is not resolved at the county level, a member or applicant can visit the Health First Colorado website in English or Spanish to learn how to make a complaint. Members or applicants can also complete a customer service survey to provide feedback about their experience at their county or eligibility site.

Partner Webinars

HCPF will be hosting quarterly informational sessions about the end of the Continuous Coverage Requirement and the COVID-19 Public Health Emergency. These webinars are geared toward community partners such as advocacy organizations, providers, and community organizations who may provide other assistance to Health First Colorado or CHP+ members (housing, social services, etc). 

The presentation and recording from the July 26, 2023, PHE Unwinding webinar are posted in the PHE Resource Center.

Next Webinar Information

When: Oct. 25, 2023, 1 - 2:30 p.m. Mountain Time

Register in advance for this webinar.

After registering, you will receive a confirmation email containing information about joining the webinar.

Contact Us

  • Please send questions about the new CCM system and Colorado Single

     Assessment & Person-Centered Support Plan to our CCM inbox.