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Updated Uniform Application
We've uploaded a new version of the Uniform Application (Version 2) effective July 1, to the HDC Provider Information webpage. All hospitals, both CICP and non-CICP, will need to update the PDF version of the application immediately on your facilities website in order to maintain website compliance.
The changes to the application include the following:
- Removed the requirement for CICP applicants to provide a Social Security number or sign a No SSN affidavit per the passing of the Medical Services Board rule change. As a clarification, this change makes no policy changes to Hospital Discounted Care.
- Adjusted so all the Unemployment pages print out
- Added Application Assistance Mapping Tool to the screening page
If a patient has already started an application on or before June 30, 2024, the application should be completed using Version 1.6. If the patient was screened on or before June 30, 2024 but does not start an application until July 1 or later, Version 2 should be used to complete their application. Any screenings or applications started July 1, 2024 or later should be completed using Version 2.
Provider Rates
Fiscal Year (FY) 2024-25 rates for Hospital Discounted Care are now available on the Hospital Discounted Care Rates webpage. While new rates for FY 2024-25 are now available, rates for FY 2023-24 will still remain accessible on the website. The appropriate rate should be applied based on date of service. Rates are divided into inpatient, outpatient, and professional service rates and apply to patients at or below 250% of the Federal Poverty Guidelines.
Medically Necessary Definition
HCPF wants to remind providers that Hospital Discounted Care includes all medically necessary services provided to patients within facilities that are subject to Hospital Discounted Care. During recent training sessions, the question of elective services was brought up. As clarification, whether a service is elective does not factor into whether a service falls under Hospital Discounted Care, as elective merely means that the service is non-emergent. Elective services are very often medically necessary. The determination of whether a service is medically necessary is made solely by the patient's physician.
Hospital Discounted Care follows the same definition of Medically Necessary as Health First Colorado, as defined below. Because of this, current Health First Colorado and/or CHP+ members are not eligible for Hospital Discounted Care.
CCR 10-2505-10, Section 8.076.1.8. Medical necessity means a good or service:
a. Will, or is reasonably expected to prevent, diagnose, cure, correct, reduce, or ameliorate the pain and suffering, or the physical, mental, cognitive, or developmental effects of an illness, condition, injury, or disability. This may include a course of treatment that includes mere observation or no treatment at all;
b. Is provided in accordance with generally accepted professional standards for health care in the United States;
c. Is clinically appropriate in terms of type, frequency, extent, site, and duration;
d. Is not primarily for the economic benefit of the provider or primarily for the convenience of the client, caretaker, or provider;
e. Is delivered in the most appropriate setting(s) required by the client's condition;
f. Is not experimental or investigational; and
g. Is not more costly than other equally effective treatment options.
FAMLI
After some research, HCPF has determined that Family and Medical Leave Insurance (FAMLI) payments will not be counted as income for Hospital Discounted Care and/or CICP. This determination was made based on the fact that FAMLI payments are not used in the determination for eligibility for Health First Colorado members under Modified Adjusted Gross Income (MAGI). For further information, you may review the FAMLI website.
Office Hours
Please continue to send your suggestions on specific topics providers would like to see discussed in Office Hours via email to hcpf_HospDiscountCare@state.co.us.
July 10: Uniform Application Live Demo
July 24: Documentation for Uniform Application
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