March 1, 2023
General Assembly Newsletter
Stay up-to-date on what's new at the Department of Health Care Policy & Financing (HCPF) 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 at the end of March.   
Please continue to direct any questions or constituent issues to HCPF's legislative team:

A Message from Executive Director Kim Bimestefer 
Kim Bimestefer
As the PHE comes to an end, please help us Keep Coloradans Covered

Health First Colorado (Colorado’s Medicaid program) has grown by about 500,000 members since the beginning of the COVID-19 pandemic. That’s the largest increase in Health First Colorado membership since Medicaid expansion, which helped connect an additional 600,000 Coloradans to affordable coverage. In accordance with federal directives, and in collaboration with our county partners, the Department will resume the standard eligibility renewal and disenrollment process beginning this May for Health First Colorado and Child Health Plan Plus (CHP+), after more than a three-year pause. The Department will take 12 months (14 months including member noticing, which begins in March) to complete the renewal process for all 1.75 million Coloradans currently covered under Health First Colorado and CHP+.

As we return to normal operations, the Department is estimating that more than 325,000 Coloradans (about 20% of current members) may no longer qualify for our safety net coverage programs, and will therefore be disenrolled beginning in May and over the 12 months that follow. Given the magnitude of this transition of Coloradans from Medicaid to commercial coverage, we are asking all stakeholders to join the Department and the Polis-Primavera Administration in a shared effort to Keep Coloradans Covered through two main pathways.

First, we invite you to help us ensure effective member awareness and engagement through the renewal process. For more information about the renewal process, videos in English and Spanish, and frequently asked questions, please visit

Second, we invite you to help us connect disenrolling Coloradans to other sources of affordable coverage to Keep Coloradans Covered. For more information about health insurance coverage types, please visit the Colorado Division of Insurance Types of Health Insurance Information page.
  • Health care providers, advocates, counties/MA sites, Case Management Agencies (CMAs), Regional Accountable Agencies (RAEs) and others who provide support services to Medicaid members, please remind your Medicaid members to update their contact information with the state, to look for and complete their Medicaid renewals, and to seek other coverage options if they no longer qualify for their current coverage. 
  • Employers, brokers and consultants, please recognize that some employees now covered through Medicaid need to be enrolled in your employer-sponsored health plans beginning in May and over the 12 months to follow. Please proactively remind your employees how to do that, recognizing the magnitude of this coverage shift.

The Department is also partnering with Connect for Health Colorado to ensure disenrolling members know how to apply for individual and family coverage and how to secure the financial subsidies that make that coverage more affordable. Connect for Health’s network of certified assisters can help. Coloradans can also apply and enroll in a plan during their special enrollment period by calling the Customer Service Center at 855-752-6749.

Due to the tremendous advances in our eligibility processes over the last few years, some members will be automatically renewed and will not need to take any action to remain covered (about 30% and growing). Others will receive a renewal packet and will need to take action (about 70%) to stay covered by the deadlines listed within this important renewal communication. We have also made significant investments in PEAK, member correspondence, our monitoring systems and our eligibility system to further the important work ahead of us. We have further worked with our county partners, sister agencies and the Joint Budget Committee to secure additional funding to assist them through this unique chapter. Last, to ensure broad alignment and communications, for many months now, the Department has been hosting stakeholder meetings. The week of Jan. 23, we met with approximately 800 county and community partners on our plans to return to normal eligibility operations. To get connected to these meetings, please visit our website.

Through the Affordable Care Act’s Medicaid expansion and collaboration across the state, between 2014 through 2016, Colorado’s uninsured rate decreased from 15.8% to about 6.6% (Colorado Health Access survey results). By continuing to work together, we have been able to maintain that 6.6% uninsured rate through the COVID-19-induced economic downturn by moving hundreds of thousands of Coloradans from commercial coverage to Medicaid - a spectacular achievement to the betterment of the health and well-being of Coloradans, employers, our providers and our state. Now, we need to partner again to reconnect what is estimated to be more than 325,000 Coloradans back to affordable commercial coverage. Our Department is stepping up to lead that industry effort, in collaboration with our sister agencies, counties, providers, advocates and a cross section of industry leaders. Our shared goal through these efforts under the Polis-Primavera Administration is clear: Keep Coloradans Covered. Look for more resources and tools in the months ahead to help us achieve our shared goal. Thank you in advance for your engagement to Keep Coloradans Covered.

Separately, on Jan. 31, the federal government announced May 11 as the end date for the public health emergency. Colorado has been preparing for this, and has already made positive policy changes, such as telehealth, permanent. Please visit our website to stay updated.

Given the increasing number of Coloradans who will be covered by commercial programs in the months to come, health care affordability is even more important. In that spirit, the Department will continue to pursue our mission to Save People Money On Health Care through thought leadership and advances in prescription drug, hospital and value based payment (VBP) policies as well as innovations that improve care affordability, access, equity and quality. In that quest, last month, the Department released three hospital transparency reports to help policymakers and communities drive solutions that save Coloradans and employers money on health care. We will be hosting a Health Cabinet Affordability Summit on March 15, 7:30-10 a.m. on affordability solutions, VBPs, rural hospital supports and shared efforts to Keep Coloradans Covered. Please register today!

Also, we invite you to keep abreast of our budget and legislative agendas in support of this important work and more.

We appreciate your continued partnership in helping Keep Coloradans Covered as the public health emergency and the continuous coverage provision come to an end. And we thank you for your leadership in driving affordable access to care and coverage for all Coloradans.
HCPF 2023 Legislative Agenda
HCPF has introduced two agenda bills this session:

HB23-1040Prader-Willi Syndrome would make a technical change to statute by removing outdated and inconsistent language related to Prader-Willi Syndrome, a rare genetic disorder that results in a number of physical, mental and behavioral complications. The bill cleared the House 61-0-4 and will be heard by the Senate Health & Human Services Committee on March 9.

HB23-1201Prescription Drug Benefits Contract Term Requirements would require that the amount charged by a Pharmacy Benefits Manager or health insurance carrier to the employer, certificate holder, or policyholder for a prescription drug be equal to or less than the amount paid by the PBM or carrier to the contracted pharmacy for the drug. The bill was introduced Feb. 15.

We are also working on Nursing Facility Sustainability and Transformation, which would implement HCPF’s recommendations from the November 2022 Nursing Facility Reimbursement Recommendations Report and ensure the nursing facility industry continues to move forward with innovative practices aimed at improving their long-term sustainability. Bill is drafted and will soon be introduced.

Removal of Most Medicaid Co-Pays, a companion bill to HCPF’s R-7 Provider Rate Adjustments budget request, would grant HCPF authority to eliminate co-pays for most Medicaid benefits.

Public Health Emergency (PHE) Unwind Alignment would ensure HCPF has the necessary state authority to continue to access federal funding related to COVID-19 response and recovery activities for the 14-month period after the end of the PHE. 

Medicaid Provider Rate Review Advisory Committee (MPRRAC) would support the JBC in enabling targeted Medicaid provider rate adjustments more frequently - every three years instead of every five. 

Community First Choice (CFC) & 1915 (c) Waiver Statute Changes - Community First Choice (CFC) is an optional program under the State Plan that allows states to offer Health First Colorado members a package of services on a state-wide basis to members who meet institutional level of care. These services will assist in accomplishing activities of daily living (ADLs), instrumental activities of daily living (IADLs), and health-related tasks including personal emergency response for individuals who require assistance. CFC draws a higher federal match than provided through home and community-based services. Under CFC, Colorado would pay 44% of program costs, gaining a 6% increased FMAP instead of the 50% it currently pays on most services. Select services that assist members with ADLs, IADLs, and health-related tasks that are currently offered through Colorado’s 1915 (c) waivers will be offered under Community First Choice after implementation. This bill removes these services from the waiver and changes eligibility for services to match Community First Choice/federal law. This bill is needed to ensure state law is aligned with federal law and to allow for full implementation of Community First Choice in Colorado. 

You can read more on our Legislative Agenda.
HCPF 2023-2024 Budget Agenda Summary
HCPF’s Budget Agenda Summary outlines discretionary budget requests submitted to the Colorado General Assembly for consideration as part of the Governor’s Fiscal Year (FY) 2023-24 budget, which runs from July 1, 2023 – June 30, 2024. 

HCPF’s budget requests focus on improving health equity for Health First Colorado (Colorado’s Medicaid program) members, stakeholder engagement, tools to improve quality and ensure compliance, supporting children and youth with complex needs, supporting Behavioral Health Administration claims processing, increasing provider rates, and improving case management to align with federal and state requirements. 

Additional detail is available on our website. The budget becomes final after the Colorado General Assembly passes the Long Bill and the Governor signs it into law.
March Health Cabinet Summit
Please register to join Lt. Governor Primavera, Health Cabinet executive directors and industry leaders for the Health Cabinet Affordability Summit hosted by the Department of Health Care Policy & Financing – March 15, 7:30 - 10 a.m. This FREE virtual event is designed for policymakers, advocates, payers, care providers, health care leaders and other industry stakeholders.

Presentations, topics and panels will include:
  • Hospital and prescription drug affordability
  • Rural hospital opportunities
  • Value based payments
  • Partnering to Keep Coloradans Covered after the end of the public health emergency

The full agenda will be posted on our website.
Hospital Reports
Earlier this month, HCPF released two reports to the General Assembly. The American Rescue Plan Act Quarterly HCBS Spending Plan Report provides a comprehensive update on HCPF’s 63 initiatives outlined in our HCBS ARPA spending plan. The Colorado Indigent Care Program and Primary Care Fund informs stakeholders and policy makers about the structure, policy, statistics, and payments related to the Colorado Indigent Care Program (CICP).

Read the reports here: 

New Legislator 101
On Feb. 15, we hosted HCPF 101: New Legislator Welcome, an introductory meeting where new legislators could learn some of the basics about the programs we administer including Health First Colorado (Colorado’s Medicaid Program), Child Health Plan Plus and other health care programs. If you would like to learn more about HCPF, you can review the Presentation Slides and Video from the webinar.

In the upcoming months, HCPF is also looking forward to hosting a series of live meetings that will take a deep dive into various aspects of Medicaid. This series will cover topics like how our budget works, Colorado’s approach to the delivery system, behavioral health coverage in Medicaid, prescription coverage and affordability initiatives, hospital costs and transparency, and the end of continuous coverage. 
HCPF Submits New Reports & LRFIs to the General Assembly
HCPF has submitted eight LRFIs to the General Assembly this year. You can find them all on our website.
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 
TheLegislator Resource Centeron 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. 

We invite legislators and legislative staff to follow us on social media to stay informed of news and happenings at HCPF. For the 2023 legislative session we are posting daily HCPF 101 facts to help you learn more about the services we provide, our members and the ways we work to keep Coloradans healthy. You can follow us on Facebook, Twitter and LinkedIn.
Follow HCPF on Social Media
We invite legislators to follow us on social media to stay informed of news and happenings at HCPF. You can follow us on FacebookTwitter and LinkedIn.