HCI Primary Care Medical Provider Monthly Newsletter

July 2022

IN THIS ISSUE:

Provider Resources:

• Coming in July: 988 Suicide & Crisis Lifeline
• Incorrect Health First Colorado Member Billing
• New National Maternal Mental Health Hotline
• Diabetes Study Patient Recruitment
• Spread the Word: Members Need to Update Their Contact Information
• Health First Colorado Member Redetermination Process
• Colorado's Youth Have Extended Access to Therapy
• Accountable Care Collaborative (ACC) Providers: Update to ACC Member Disenrollment Rules
• Home and Community Based Services Rate Increases
• Home and Community Based Services for Persons with Intellectual and/or Developmental Disabilities Waiver Programs
• Provider Directory Contact Reminder
• Provider Handbook

COVID Information:

• Stay Up To Date With the Public Health Emergency Declarations
• COVID-19 Therapeutics Program for Health Care Providers
• CDPHE Quick COVID Provider Guide
• State Wide Vaccine Information

Events & Webinars

COMING IN JULY: 988 SUICIDE & CRISIS LIFELINE

As the nation continues to prepare for the July 16, 2022, transition to 988 as the easy-to-remember, three-digit dialing, texting, and chat code for anyone experiencing a suicidal or mental health related crisis or emotional distress, it's important that messaging efforts are aligned, coordinated, and consistent. To help achieve this, the Action Alliance encourages partners to continue to use the recently released 988 Messaging Framework as you are planning for and developing your 988-related messages. In addition, the Substance Abuse and Mental Health Services Administration (SAMHSA) developed a 988 Partner Toolkit to equip the field with key messages, answers to frequently asked questions, branding guidelines, etc.

INCORRECT HEALTH FIRST COLORADO MEMBER BILLING

From Colorado Department of Health Care Policy & Financing

Health First Colorado members cannot be billed for services covered by Health First Colorado.

Providers cannot bill members in the following circumstances:

• Third-Party Liability (TPL) co-pays and deductibles - Providers cannot bill members 

      for the difference between commercial health insurance payments and the billed 

      charges when Health First Colorado does not make additional payment. The provider 

      also cannot bill members for co-pay or deductibles assessed by Third-Party Liability 

      (TPL) (commercial insurance). Refer to the General Provider Information Manual for more 

      information.

• Delayed Notification of Eligibility from the member - Providers must verify eligibility 

      within a timely manner.

• Claim denials - Timely filing, place of service invalid, contract invalid, or other 

      denials for the line item or the entire claim are not valid reasons to bill the member.

• Provider is not enrolled with Health First Colorado - Once the services have been 

      rendered to the member, the provider must enroll with Health First Colorado in order 

      to receive payment. The provider may not bill the member if they choose to not 

      enroll.

Providers shall not send overdue Health First Colorado member accounts to collection 

agencies unless the billing is for a non-covered service and the member has reneged on a 

written payment agreement.

Visit the Policy Statement: Billing Health First Colorado Members for Services web page for more information.

NEW NATIONAL MATERNAL MENTAL HEALTH HOTLINE

The new National Maternal Mental Health Hotline provides 24/7, free, confidential support, resources and referrals to any pregnant and postpartum mothers facing mental health challenges and their loved ones. The service is available via phone and text in English or Spanish.

Call or text, 1-833-9-HELP4MOMS (1-833-943-5746) to connect with counselors at the National Maternal Mental Health Hotline.

Pregnancy and a new baby can bring a range of emotions. In fact, many women feel overwhelmed, sad, or anxious at different times during their pregnancy and even after the baby is born. For many women, these feelings go away on their own. But for some women, these emotions are more serious and may stay for months. The National Maternal Mental Health Hotline’s counselors provide real-time emotional support, encouragement, information, and referrals. Pregnant and postpartum women can get the help and resources they need, when they need it.

For more information, visit this webpage.

DIABETES STUDY PATIENT RECRUITMENT

A diabetes study is being conducted by Tamara Oser, MD and Sean Oser, MD, MPH of the Department of Family Medicine University of Colorado Anschutz Medical Campus. Your patients may qualify if they:

• Are over 18 years of age
• Have been diagnosed with type 1 diabetes
• Have an interest in diabetes technology

Eligible participants are adults 18-89 years old with Type 1 Diabetes diagnosed at least 1 year ago, treated with injections (not an insulin pump). Study participation will consist of two 14-day periods as outpatients, virtually or in-person.

Please review this flyer. If providers need more information or have questions, please reach out to either:

Sean Oser sean.oser@cuanschutz.edu  717-552-6333 

Tamara Oser tamara.oser@cuanschutz.edu  717-552-6334

SPREAD THE WORD: MEMBERS NEED TO UPDATE THEIR CONTACT INFORMATION

Please help spread the word to Health First Colorado (Colorado’s Medicaid program) members to update their contact information. During the public health emergency (PHE), members stay enrolled in health coverage even if they have household or income changes. At the end of the PHE, many Health First Colorado members will receive a packet to renew their coverage. Members who fail to fill out necessary information may lose their benefits.

Many members have moved over the past few years. It is crucial that they have updated their address so that they get the information they need to keep or change their coverage. Share these flyers, English and Spanish, with your patients. More information about this campaign can be found here.

HEALTH FIRST COLORADO MEMBER REDETERMINATION PROCESS

In March 2022, a new redetermination process for all Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus (CHP+) members was implemented.  For more information on how this impacts providers and why it is important, see the Renewal Revamp presentation, workbook and FAQ on HCPF's Eligibility Partner Trainings webpage or view the Renewal Guidance for Medical Assistance Memo. Refer individuals to this link for information on finding a provider within your region.

COLORADO'S YOUTH HAVE EXTENDED ACCESS TO THERAPY



The I Matter program will receive an additional $6 million in American Rescue Plan Act funding following the passage of House Bill 22-1243. Colorado’s youth will now have continued access to free therapy sessions until at least June 30, 2023. The program, which launched last Oct. 27, provides accessible, confidential and non-judgmental behavioral health services to any Colorado youth.

ACCOUNTABLE CARE COLLABORATIVE (ACC) PROVIDERS: UPDATE TO ACC MEMBER DISENROLLMENT RULES

From Health Care Policy and Financing (HCPF)

Effective June 15, 2022, ACC disenrollment rules will be updated. Previously, when a Primary Care Medical Provider (PCMP) updated their accepted age ranges for member enrollment, the change would not affect enrolled members. Beginning June 15, when a PCMP updates the accepted age ranges, all geographically attributed members who fall outside the PCMP’s accepted age ranges will be disenrolled at the end of the month in which the updates are made. This change will not affect members who are attributed via client choice or via claims history. PCMPs should work with the Regional Accountable Entities (RAEs) to ensure that all accepted age ranges are accurate.

Contact HCPF_accenrollment@state.co.us for more information.

HOME AND COMMUNITY BASED SERVICES (HCBS) RATE INCREASES

A temporary rate increase using Home and Community-Based Services (HCBS) American Rescue Plan Act (ARPA) funding was implemented on Nov. 4, 2021. A 2.11% increase has been applied retroactively to April 1, 2021, and will be in effect through July 31, 2022, but providers must submit or adjust previously paid claims.  

Do not lose out on the increase. Be sure to submit your claims or adjust your paid claims ASAP!

Operational Memo 21-072 outlines how providers go about billing the increased amounts. 

HOME AND COMMUNITY BASED SERVICES FOR PERSONS WITH INTELLECTUAL AND/OR DEVELOPMENTAL DISABILITIES WAIVER PROGRAMS

The Home and Community Based Services (HCBS) waiver programs provide Health First Colorado members who meet special eligibility criteria access to additional services in their homes and communities as an alternative to institutional care. Level of care determinations are made annually by the case management agencies (aka Community Centered Boards). Members must meet financial and medical eligibility, as well as program-specific criteria to access services under a waiver. The applicant must be at risk of transition to a nursing facility, hospital, or Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). To utilize waiver benefits, members must be willing to receive services in their homes or communities. For more information, click here to be taken to the Department of Health Care Policy and Financing's webpage regarding this program.

STAY UP TO DATE WITH THE PUBLIC HEALTH EMERGENCY DECLARATIONS

Keep updated on the public health emergency declarations for COVID-19 by visiting this site.

COVID-19 THERAPEUTICS PROGRAM FOR HEALTH CARE PROVIDERS

In an ongoing effort to decrease hospitalizations for at-risk Coloradans by ensuring access to COVID-19 therapeutics, we are sharing information provided by the Colorado Department of Public Health and Environment (CDPHE) for health care providers. Included here is updated National Institutes of Health (NIH) recommendations, as well as provider eligibility and enrollment information for both the CDPHE Therapeutics program and Health and Human Services (HHS) Test to Treat program, Health care providers are encouraged to learn more about these lifesaving treatments and talk about them with patients who may be eligible to receive them.

HEALTH CARE POLICY & FINANCING (HCPF) ANNUAL STAKEHOLDER WEBINAR

Join Health Care Policy & Financing leaders for a virtual webinar where they will share what has been accomplished together last year, address priorities for next fiscal year, and invite stakeholder feedback and comments. 

• Tuesday, July 19, 2022  9am - 11am (MST)
• Click here to register.

July 2022