HCPF develops county-by-county Medicaid fact sheet

The Department of Health Care Policy and Financing (HCPF) offers a new resource that provides information about the impact of Medicaid expansion and Medicaid spending by county. The county fact sheets contain Medicaid caseload information and the local RCCO and BHO data. Medicaid funding is broken out by medical spending on children, Non-Expansion and Expansion adults.

The Department will update the fact sheets on an annual basis. The next update will likely be in late March/early April 2016 (after claims run out for the 2015 calendar year).

CDPHE policy for providing information about Medicaid or Connect for Health Colorado

Please see the memo creating a standard policy that all CDPHE contractors that provide direct clinical services provide Colorado Medicaid and Connect for Health Colorado information to clients presenting for services at their agencies.​ This policy closely aligns with the policy WWC implemented this year regarding referral to Connect for Health Colorado for assessment of eligibility or subsidized Marketplace health insurance coverage (See page 4 of the Eligibility Section of the Toolkit for more information). 

WWC will begin implementing this new policy with future revisions of the Toolkit and in future contracts for Clinical Services, Care Coordination and WISEWOMAN.

​Please contact myself, Emily Kinsella with any questions.

Remember: Check insurance status before each procedure!

Recently we have had a few agencies report to us that clients seen through WWC Clinical Services last fiscal year (June 30, 2014 to June 29, 2015) were actually billed to and paid by Medicaid. While agencies are not required to switch funding from WWC Clinical Services to Medicaid for services rendered between the client’s enrollment notification date and back-dated enrollment date, it is not allowable to charge the same service to two funders (i.e., WWC Clinical Services and Medicaid). When another funder has been charged for services rendered in a previous fiscal year, agencies must refund CDPHE funds paid for these services by sending CDPHE a check. If your agency identifies a change in funding source for services performed during the active fiscal year, simply update the funding source for affected procedures and the funds will be automatically reversed on your next grant activity statement.

While we know this may be inevitable for services performed last fiscal year, below are some best practices to help you avoid this in the future. We will remind agencies during our major mid-year and end-of-year data entry pushes. 

• Follow the new policy that insurance status be assessed before each clinical service is provided with WWC funds. 
• Verify regularly that WWC Clinical Services clients have not retroactively been billed to Medicaid. 

Please contact Emily, Marina or your WWC program coordinator with any questions.

2 Webinar Opportunities from the Centers for Medicare and Medicaid Services

• Special Enrollment Periods and Resources for the Uninsured)

September 29 at 3:00 pm ET
(2:00 pm CDT, 1:00 pm MDT, Noon PDT)
Register

Individuals and families can enroll in the Health Insurance Marketplace during special enrollment periods if they experience certain circumstances. Special Enrollment Period circumstances include graduating from college and losing health insurance, getting married or divorced or having a baby, losing employer insurance or turning 26 and losing coverage on a parent’s health plan. Join this webinar to learn more about special enrollment periods and how to enroll in the Health Insurance Marketplace. For those who are uninsured and don’t qualify for the special enrollment period, learn what resources are available and when to enroll in the Health Insurance Marketplace.

• Best Practices in ACA Outreach and Enrollment

October 8 from 2 pm – 3:30 pm ET
(1:00 pm CT, Noon MT, 11:00 am PT)
Register

Learn from faith leaders who have conducted successful outreach and enrollment campaigns before and during open enrollment. On October 8, we will hear from Abrar Quader from the Compassionate Care Network (CCN) which helped enroll people who are Muslim, Hindu and Sikh. CCN received a navigator grant from the Illinois state marketplace.

Quick Guide: BCCP Medicaid

Do you have a question about Breast and Cervical Cancer Program (BCCP) eligibility? Do you need to know how to apply for BCCP if your client was diagnosed with an eligible diagnosis outside of a WWC clinic?

Colorado’s Department of Health Care Policy and Finance (HCPF) BCCP website will assist you in determining BCCP eligibility and income limits, as well as the benefits and services available once approved. If your client was not diagnosed through a WWC clinic, you will find a step-list on how to apply as a non-WWC BCCP, including the Non-WWC Provider Attestation form.

As always, you can also contact your program coordinator or the nurse consultant for assistance with BCCP and questions or concerns.

Promote preventive services for your Medicaid clients

The Centers for Medicare & Medicaid Services is offering a set of engaging materials to help Medicaid and CHIP beneficiaries understand and access preventive services available to them.

Living Well is a set of outreach and education materials that connects preventive care in the clinical setting with everyday life. The Living Well toolkit features a number of customizable posters, fact sheets, social media posts, and strategies for getting the word out about Medicaid coverage of preventive services.

Visit the Medicaid website for a toolkit, posters, factsheets, social media graphics, and image library. 

Provider Revalidation and Enrollment Made Easy!

Beginning September 15, 2015, all Colorado providers who want to continue, or begin, providing services to Medicaid and CHP+ members after March 31, 2016 will be required to revalidate and enroll under new federal enrollment screening criteria. To meet these new requirements, as well as to ensure that you are enrolled in HCPF's new claims processing system, Colorado providers must revalidate using the new Online Provider Enrollment (OPE) tool. Although the new OPE tool will launch in September of 2015, HCPF is asking that you complete your revalidation during your assigned revalidation and enrollment wave.

How to Determine Eligibility

What assistance am I eligible for? What programs are available? You probably hear these questions many times a day. 

One of the first steps in the Care Coordination Grant Program is determining if the client is eligible for Medicaid or subsidies through the exchange. Colorado PEAK provides this "Am I Eligible?" tool.