January 20, 2021
General Assembly newsletter
Stay up-to-date on what's new at the Department of Health Care Policy & Financing with our newsletter created specifically for the Colorado General Assembly.
Editor's Note
This newsletter is published monthly while the legislature is in session, and quarterly outside of the legislative session. The next edition will be published in February 2021.

Please continue to direct any questions or constituent issues to the Department's legislative team:
HCPF 2021 Legislative Agenda 
A brief overview of the Department’s legislative agenda can be found on the Department’s website. This year, our agenda bills focus on: 
  • Telemedicine Policy Refinements 
  • Case Management Redesign 
  • Skilled Nursing Facilities: Demonstration of Need and Technical Changes 
  • Add Remote Supports to Home and Community-Based Services (HCBS) Programs 
  • Expand Canadian Prescription Drug Importation Program 
You can find the agenda here.

HCPF FY 2021-22 Budget Agenda
A summary of the Department's discretionary budget requests submitted for consideration to the Colorado General Assembly, as part of the Governor's Fiscal Year (FY) 2021-22 budget, is now posted on our website. As a result of the COVID-19 pandemic, the budget requests focus on addressing the state’s current budget shortfall while still prioritizing and protecting member benefits and services given budget constraints. 

A summary of the Department's discretionary budget requests submitted for consideration to the Colorado General Assembly, as part of the Governor's Fiscal Year (FY) 2021-22 budget, is now posted on our website.
Joint Budget Committee (JBC) Hearing 
The Department recently presented to the JBC on the Department’s three sections (Executive Director's Office, Office of Community Living and Behavioral Health). All of our hearing responses and presentation materials can be found on the Legislator Resource Center page.
Public Health Emergency (PHE) Extended 
Health and Human Services Secretary Azar has formally extended the Public Health Emergency (PHE). The PHE can be extended for up to 90 days at a time. This extension starts Jan. 21, 2021 and would end, unless extended again, on April 20, 2021. We will continue to keep you updated directly and via our Public Health Emergency Planning page. 
Polis Administration Releases New Prescription
Drug Report 
The Department recently released the 2nd edition of Reducing Prescription Drug Costs in Colorado – Cost Drivers and Strategies to Address Them.  

One of the key findings in the report is that less than 2-percent of the drugs being prescribed to Coloradans are so expensive, they are driving nearly 50-percent of total prescription drug expenditures. Without federal price controls, manufacturers are bringing drugs to market at prices that are unsustainable and then using their lobbying power and patent lawyers to impede competition from generic manufacturers that would help reduce prices. 
The report was discussed along with other federal and state level policy changes at the Colorado Health Cabinet Policy Summit earlier this week. A full recording of the Summit is available here. 

Substance Use Disorder (SUD) Benefit Update 
On Jan. 1, 2021, the Department expanded substance use disorder coverage for Health First Colorado (Colorado’s Medicaid Program) members. This expanded coverage will provide members greater assistance on their road to recovery from drug and alcohol addiction. In accordance with HB 18-1136, the Department added inpatient and residential components, including withdrawal management, to the continuum of outpatient substance use disorder services currently available. With these additions, the full continuum of care will be covered for eligible members. 
 
For more information about this benefit expansion, including an FAQ and SUD Provider Manual, visit our webpage, or email questions to hcpf_sudbenefits@state.co.us.
Share how we're providing life-saving care to people across Colorado.
Even Coloradans who never thought they'd need public health insurance are being served by Health First Colorado (Colorado's Medicaid program).  
 
Following a traumatic brain injury, Mike received life-saving care at no cost thanks to Health First Colorado. Watch Mike’s story and listen to Health First Colorado members tell in their own words how Health First Colorado was there to help. Other Health First Colorado members want Coloradans to know that they may qualify for quality health care coverage. Most Coloradans who apply online learn immediately whether they qualify. 
 
Please help us spread our message by sharing videos where real members tell their stories about getting quality health care through Health First Colorado. It's easy to share! Just visit our member video toolkit to find copy-and-paste messaging and videos to upload to your social media channels. 
Electronic Visit Verification (EVV) Update 
Electronic Visit Verification (EVV) is an electronic system that verifies home and community-based service visits by documenting six points of data, including the type, date, and location of service; the individuals receiving and providing the service; and the time service begins and ends. On August 3, 2020, EVV became mandated by Colorado Code of Regulation 2505-10 8.001. 
 
The Department is utilizing a tiered implementation strategy to allow providers time to familiarize themselves with the use of EVV, minimize long-term administrative burden, and reduce financial impact when EVV records are required prior to claim adjudication.  
The Department has recently shifted the timeline for prepayment claim review, which was originally scheduled to begin on January 1, 2021. These changes are outlined below and further described in Operational Memo 21-007.  
 
Claim Suspension  
January 16, 2021 – February 28, 2021  
EVV-required claims from providers who are not making an earnest effort to utilize EVV will be suspended.  
  • Providers whose EVV-required claims are being suspended must provide a written implementation plan to the Department. 
  • Providers who are making an earnest effort to utilize EVV will not experience disruption in payment at this time.  
  • Pre-Payment Claim Review  
  • Beginning March 1, 2021 
  • All EVV-required claims submitted to the Department must be matched to a valid EVV record to pay. 
  • Due to the unique payment structure of Hospice services, Hospice claims are exempt from pre-payment review. Hospice claims are subject to compliance monitoring and over-payment recovery only. 
 
Additional Information 
The Department has released and continues to improve the EVV Program Manual. Four EVV stakeholder meetings are held monthly, more information on these meeting can be found on the EVV stakeholder meeting webpage. For additional EVV resources visit the Department EVV webpage or email EVV@state.co.us.  
Hospital Transformation Program 
Rural Support Payment Update 
At the Dec. 15, 2020 Colorado Healthcare Affordability and Sustainability Enterprise (CHASE) Board meeting, board members provided input and voted to approve the HTP Rural Support Payment framework and timeline. 
 
On Dec. 3, 2020, a list of qualified hospitals was shared with program participants and stakeholders. Approval from the CHASE Board marks the beginning of the attestation process for qualified hospitals, with a due date of Friday, Jan. 22, 2021. The Provider Attestation Form, along with additional information about the Rural Support Payment, can be found in the Rural Support Payment section of the HTP website. Funds are expected to become available in Spring 2021. Please direct additional questions to the dedication Rural Support Payment inbox. 
 
Program Updates 
As we continue to move closer to HTP implementation, updated documents have been posted to the HTP website: 
HTP Scoring Framework, including updated an update timeline, at-risk tables, and benchmark methodologies by measure. 
 
Please direct any questions about these updated documents to the HTP inbox. 
 
Community Advisory Council 
Community Advisory Council meetings continue to take place on a monthly basis with the next meeting taking place on Monday, Jan. 25. The agenda, meeting materials and previous meeting notes can be found on the Community Advisory Council website. 
 
CHASE Board meeting 
The next Colorado Healthcare Affordability and Sustainability Enterprise (CHASE) Board meeting will take place via webinar on Tuesday, Feb. 23 at 3 p.m. Additional information about the board, as well as meeting materials, can be found on the CHASE Board website. 
HCPF Submits New Reports & LRFIs to the
General Assembly 
HCPF submitted new reports and LRFIs to the General Assembly since the last newsletter, all are on the Legislator Resource Center page: 
 
Medicaid Snapshot and County-by-County Resources  
These county fact sheets provide an annual snapshot by fiscal year for Health First Colorado (Colorado's Medicaid Program) activity including average annual caseload and top five claim types for each county.  
Legislator Resource Center 
The Legislator Resource Center on our website is available to help legislators and legislative staff easily find information. It includes links to reports, fact sheets and overviews of the budget process to help inform legislators. 
Follow HCPF on Social Media
We invite legislators to follow us on social media to stay informed of news and happenings at the Department. You can follow us on Facebook, Twitter and LinkedIn.