In this issue:

• COVID-19
• COVID-19 Therapeutics Program for Health Care Providers
• FREE COVID-19 Self Tests
• Stay Up To Date With the Public Health Emergency Declarations
• Colorado COVID-19 Health Care Provider Vaccine Information Toolkit
• Statewide COVID-19 Vaccine Information
• Provider Resources and Information
• July is National Minority Mental Health Awareness Month
• Coming in July: 988 Suicide & Crisis Lifeline
• New National Maternal Mental Health Hotline
• One Colorado Resources for Providers
• Colorado Medicaid Provider Rate Adjustments
• Billing Under a Licensed Behavioral Health Clinician
• Update to Uniform Services Coding Standards (USCS) Manual
• Incorrect Health First Colorado Member Billing
• Diabetes Study Patient Recruitment
• Health First Colorado Member Redetermination Process
• Spread the Word: Members Need to Update Their Contact Information
• Home and Community Based Services for Persons with Intellectual and/or Developmental Disabilities Waiver Programs
• UPDATED Behavioral Health Outpatient Authorizations
• Home and Community Based Services Rate Increases
• ICYMI: RAE Roundtable Behavioral Health Resources
• Behavioral Health Claims and Billing Information
• Provider Handbooks
• Care Coordination and Behavioral Health Providers Fact Sheet
• Upcoming Events and Webinars

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.

FREE COVID-19 SELF TESTS

Residential households in the U.S. are now eligible for another order of free COVID-19 self- tests on USPS.com.

• Each order now includes 8 rapid antigen COVID-19 tests
• Orders will come in 2 separate packages (4 tests in each package), each with its own tracking number and will ship for free

Self- tests for COVID-19 give rapid results and can be taken anywhere, regardless of your vaccination status or whether or not you have symptoms. They give your result in a few minutes and are different from laboratory-based tests that may take days to return your result. 

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.

COLORADO COVID-19 HEALTH CARE PROVIDER VACCINE INFORMATION TOOLKIT

In an effort to best organize and make readily available the wide array of health care provider vaccine resources, trainings and materials related to the COVID-19 vaccination program, the Colorado Department of Public Health and Environment (CDPHE) has created the online Colorado COVID-19 Health Care Provider Vaccine Information Toolkit. The toolkit has a variety of robust elements for providers to use.

JULY IS NATIONAL MINORITY MENTAL HEALTH AWARENESS MONTH

Even though most of the things we need to be mentally healthy are universal — like safe housing, supportive relationships and good health care — a one-size-fits-all approach to mental health care just isn’t enough. We know that people from ethnic and cultural communities are, in general, less likely to receive necessary mental health services and those who are in treatment often receive poorer-quality care. Those who do seek help also may have difficulty obtaining mental health care from professionals who speak their language and/or understand and respect their cultural values. What can you do to promote better mental health in diverse communities?

Visit the U.S. Department of Health and Human Services Office of Minority Health webpage for extensive information and resources. You can also find some great information from NAMI on the Bebe Moore Campbell National Minority Mental Health Awareness Month webpage.

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.

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.

ONE COLORADO RESOURCES FOR PROVIDERS

One Colorado is the state’s leading advocacy organization dedicated to advancing equality for lesbian, gay, bisexual, transgender, and queer (LGBTQ) Coloradans and their families. They effectively advocate for LGBTQ Coloradans and their families by lobbying the General Assembly, the executive branch, and local governments on issues like safe schools, transgender equality, relationship recognition, and LGBTQ health and human services. This link offers guidance and resources to improve care provision, create more inclusive and welcoming spaces, and opportunities for further training and education as providers.

COLORADO MEDICAID PROGRAM PROVIDER RATE ADJUSTMENTS

Health First Colorado (Colorado’s Medicaid program) across-the-board provider rate increases were approved by the Joint Budget Committee during the 2022 legislative session and are effective for dates of service beginning July 1, 2022, pending State Plan Amendment (SPA) approval from the Centers for Medicare and Medicaid Services (CMS) prior to implementation. The fee schedules located on the Provider Rates & Fee Schedule web page have been updated to reflect the 2.0% across-the-board rate increases. Rates will be updated in the Colorado interChange for dates of service beginning July 1, 2022. Any category of service or subset of individual services within a category receiving a targeted rate increase mentioned in other bulletin articles are not eligible for the across-the-board increase. Contact Victoria Martinez at Victoria.L.Martinez@state.co.us with questions or concerns. 

BILLING UNDER A LICENSED BEHAVIORAL HEALTH CLINICIAN

Effective May 1, 2022, language was provided to allow newly licensed behavioral health providers to continue to bill under a supervisor (licensed behavioral health clinician) while pursuing contracting with a Regional Accountable Entity (RAE). This is being expanded to allow newly hired licensed behavioral health providers with a group practice to bill under a supervising behavioral health clinician while the provider is working toward credentialing and contracting with a RAE.

Effective July 1, 2022, this policy understanding will be reflected in the Uniform Service Coding Standards Manual with the following language:

Practitioners who are enrolled with Medicaid and have applied for credentials with a Regional Accountable Entity (RAE) may submit claims under a supervising provider for a maximum of 90 days while completing contracting with a RAE.

This policy applies to:

• Newly licensed BH providers who were providing services to members under clinical supervision while they were working toward licensure.
• Licensed BH providers who are hired by a group practice.

Contact John Laukkanen at John.Laukkanen@state.co.us with questions about this policy.

UPDATE TO UNIFORM SERVICES CODING STANDARDS (USCS) MANUAL

Effective July 1, 2022, a new edition of the USCS Manual contains significant formatting and content updates. Providers are strongly encouraged to review the guidance pages and appendices in this manual for new information. The USCS Manual can be found on the Accountable Care Collaborative Phase II Provider and Stakeholder Resource Center web page. Contact hcpf_bhcoding@state.co.us with questions related to this manual.

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.

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

HEALTH FIRST COLORADO MEMBER REDETERMINATION PROCESS

In March 2022, a new redetermination process to determine eligibility for all Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus (CHP+) members was implemented.  For more information, see the Renewal Revamp presentation, workbook and FAQ on HCPF's Eligibility Partner Trainings webpage or view the Renewal Guidance for Medical Assistance Memo. 

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. Please use this flyer, English and Spanish, to share with your Health First Colorado members. More information about this campaign can also be found here.

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.

UPDATED BEHAVIORAL HEALTH OUTPATIENT AUTHORIZATIONS

Northeast Health Partners (Regional Accountable Entity) is contracted with the Colorado Department of Health Care Policy and Financing (HCPF) to manage Health First Colorado behavioral health benefits through the Colorado Community Behavioral Health Services Program. NHP is contracted with Beacon Health Options and has delegated oversight of utilization management programs to Beacon. HCPF will continue to manage and pay for physical health benefits. HCPF will handle appeals for a Notice of Adverse Benefit Determination related to any physical health denial.

Outpatient services which are considered "routine" do not require prior authorization. Those include the following codes: 0510, 0513, 90791, 90792, 90832, 90834, 90837, 90839, 90846, 90847, 90849, 90853, 96372, H0001, H0002, H0004, H0005, H0006, H0018, H0020, H0023, H0025, H0031-34, H0036-38, H2000, H2014-18, H2021, H2022, H2027, H2030, H2031, S9445, S9453, S9454, T1017, T1023 and all E&M codes. 

• Medication Assisted Treatment (MAT) no authorization (for in-network providers)
• Intensive Outpatient Program (IOP) needs authorization

This information can be found in the Behavioral Health Provider Handbook located on the NHP website.

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. 

IN CASE YOU MISSED IT: RAE ROUNDTABLE BEHAVIORAL HEALTH RESOURCES

Here is a link to resources that were offered in previous Beacon RAE Roundtables, including information on Zero Suicide, the Public Health Emergency (PHE), and authorizations.

BEHAVIORAL HEALTH CLAIMS AND BILLING INFORMATION

Beacon Colorado Provider Relations team previously hosted a training on behavioral health billing and claims. If you missed the training or need a refresh, please click here and it will take you to the NHP webpage where you can access the Zoom recording and slides.

RAE ROUNDTABLE BEHAVIORAL HEALTH---2nd Fri of every month at 11am

Please join the Beacon Colorado Provider Relations team every month for relevant behavioral health trainings, resources, and discussion. Click here to join the webinar. 



Or By Telephone:1-669-900-6833---Webinar ID: 995 7438 8100---Passcode: 173943

Visit the NHP website for details on previous calls.

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.

CLAIM SUBMISSION GUIDELINES--WEBINAR

Hosted by Beacon Health Options

This live training provides an overview of billing and claims information and how to submit claims to Beacon Health Options along with reviewing best practices and avoiding claim denials.

• Wednesday, July 20, 2022   12pm (MST)
• Click here to register.

MOTIVATIONAL INTERVIEWING--WEBINAR

Hosted by Beacon Health Options

In this 2-hour training, attendees will learn the theory & principles behind Motivational Interviewing as well as processes & techniques healthcare providers can use to implement Motivational Interviewing into their practice. This is an introductory level topic training. No CE credit is associated with this training.

• Wednesday, July 20, 2022   1pm (MST)
• Click here to register.

CREDENTIALING AND RE-CREDENTIALING FOR BEACON PROVIDERS--WEBINAR

Hosted by Beacon Health Options

This webinar will be an overview of credentialing for solo practitioners, facilities and groups.

• Wednesday, July 27, 2022  12pm (MST)
• Click here to register.

GRIEF AND LOSS: CONSIDERATIONS FOR MENTAL HEALTH PROFESSIONALS--WEBINAR

Hosted by Beacon Health Options

Grief and loss are difficult human experiences that will often lead individuals to seek support via mental health care. This 2 hour training will explore various types of grief and loss, grief-related diagnoses in the DSM-5, theories and myths, grief-targeted therapy interventions, and ways that professionals can mitigate their own risk while working with grieving clients. There is no CE credit or certification associated with this training.

• Wednesday, July 27, 2022   1pm (MST)
• Click here to register.

2022 ANNUAL BEHAVIORAL HEALTH TRAINING CONFERENCE

Colorado Behavioral Healthcare Council (CBHC) is hosting the largest Behavioral Health Conference in the state of Colorado. Each year, hundreds of behavioral health specialists, members of the state and criminal justice system, physical health providers, and university students attend CHBC’s annual behavioral health conference. The conference focuses on best clinical and business practices in behavioral health. They have a great lineup of presenters, including keynote speakers, Dr. Morgan Medlock and Daniel Lerner.

• September 21, 2022 through September 24, 2022
• Beaver Run Resort & Conference Center in Breckenridge, Colorado
• Click here for detailed information and to register.

July 15, 2022