Navigator - Provider Newsletter from Colorado Access

Dear Health Community Colleague,

Welcome to the May Navigator. In this issue, you’ll find information about the end of the public health emergency, signing up for a behavioral health provider focus group sponsored by the Department of Health Care Policy and Financing (HCPF), a Colorado Access provider form, the new BHOPE process, and information about the HO modifier, in addition to other important information.

If you want to learn more about anything in this issue of the Navigator or just have a question, please contact us. You can also connect with us on any of our social media channels using the links below.

In good health,
Colorado Access

The License panels of the state’s Provider Enrollment Portal and the Provider Web Portal (Provider Maintenance function) have been updated. Additional information is now required when adding a new license or updating/renewing an existing license (enrolled providers only).

Refer to page 2 here for additional information, or refer to the Quick Guides here for all published HCPF Provider Web Portal Quick Guides. All Child Health Plan Plus (CHP+) and Health First Colorado (Colorado’s Medicaid Program) providers must revalidate every five years. Click here for more information.

We administer a member survey to get real-time member feedback on quality of services and providers, access to care, and satisfaction with services. As of 2022, we have initiated and administered three member satisfaction surveys, gathering more than 2,800 responses from June 2020 through December 2021. These surveys help us highlight deficiencies and generate ideas on how we can better serve our members, and the data we collect from them helps us drive improvement efforts.

Check out the results from the member surveys here.

Many of us have seen the secondary impact of COVID-19 on our patients with chronic conditions. Some of us have come up with creative ways to ensure quality care for these patients. We hosted a clinical provider meeting to allow clinicians to learn from each other and highlight this important work. Providers from Regions 3 and 5 of Colorado discussed how they worked on gap closure, engaging patients from the periphery (those who are attributed but unengaged), coordinated care across systems (specifically primary care and behavioral health), and used innovation to provide quality care.

As vaccination rates remain lower than pre-pandemic levels, we join our public health partners in a call to get all people — especially children who are at high risk for vaccine-preventable diseases — up-to-date with needed vaccinations.

What you can do:

Download resources (digital media toolkit included) to encourage everyone to stay on track with their child's routine checkups and vaccinations
Share resources to highlight the importance of community vaccine protection
Encourage friends, family and patients who are eligible for a COVID-19 vaccine booster to get one

Join us on Thursday, May 19th at 12:00 p.m. for an ECP provider forum focused on the new administrative payment model that goes live on July 1, 2022. Click here to register.

If your site is designated as a PCMP or PCMP+ then you should attend the provider forum on Tuesday, May 17th at 12:00 p.m. instead. Click here to register.

Both forums will review the new metrics included in the model, along with how per-member-per-month payments are determined.

Refugee and Immigrant Learning Series
More refugee and immigrant families with complex health needs have been coming into the Colorado health care system and there is need for more training to support them culturally as they navigate this change. We have partnered with the Colorado Department of Human Services (CDHS) to offer a free, virtual learning series to help you in your work to support the unique refugee and immigrant community. Please see the attached flyer to learn more about this series.

Digital Diagnostics Devices - Webinar
There are an increasing number of connected diagnostic devices that can be used in primary care environments to help increase efficiency, reduce errors and improve patient care for one facility or across a network of sites. Join this webinar on Thursday, May 19th at 10:00 a.m. to learn how digital diagnostic devices can help improve clinical workflows and make detection at the primary care level simple and effective, creating a better health care experience. Register here.

May was chosen for Asian American Pacific Islander (AAPI) Heritage Month because it commemorates the first Japanese people immigrate to the United States on May 7, 1843 and because it recognizes Golden Spike Day, May 10, 1869, which marks the completion of the transcontinental railroad that was built with significant contributions from Chinese workers.

The term AAPI includes cultures from all across Asia, including East, Southeast, and South Asia, as well as the Pacific Islands of Melanesia, Micronesia, and Polynesia. As of 2019, there were about 22.9 million people of Asian or Pacific Islander descent in our country, which accounts for about 7% of the population in the United States.

Colorado has a deep history involving people from Asian cultures who immigrated to the United States after the Civil War. Some of that history is painful, while other stories highlight the extraordinary resilience and courage. For example, in 1870, Denver boasted a robust Chinatown where businesses and activities thrived within the Chinese community. In what is now LoDo, this area was the residential and business center of the Chinese community, and yet, only a commemorative plaque remains on the corner of 20th and Blake streets.

Mental Health Awareness Month has been observed in the United States since 1949. Each year millions of Americans face the reality of living with a mental illness. The National Alliance on Mental Illness, NAMI, works to fight stigma and advocate for policies that support people with mental illness and their families. The work nationally has guided many state leaders and advocates to fight for equity at the state and local level.

In Colorado, where 1 in 5 people are living with a mental illness, the need for advocacy continues. Recently we had much to celebrate regarding Colorado’s efforts to raise awareness, as leaders across the state gathered to proclaim May as Mental Health Awareness Month in Colorado, a proclamation signed by Governor Polis and supported by a variety of other leaders.

Per current Medicare rule, licensed marriage and family therapists (LMFT), licensed professional counselors (LPC), and licensed addiction counselors (LAC) are not allowed to bill Medicare for behavioral health services.

HCPF has requested that effective July 1, 2022, if these behavioral health provider types see any RAE members who have dual coverage (Medicaid/Medicare), they are required to bill the “HO” modifier in the 2nd, 3rd or 4th position on professional claims sent to the RAEs. This change will be reflected in the July 1, 2022 Uniform Service Coding Standards Manual. We will pay these claims as the primary payer and an EOB from Medicare is not required with submission.

Arrow Performance Group (APG) is conducting 20 provider focus groups with independent behavioral health providers, on behalf of HCPF. The main goal is to address recent behavioral health provider complaints, establish a mutual understanding of issues and opportunities, and build collaborative communication and stronger relationships. The focus groups provide an opportunity for behavioral health providers to give feedback to help improve collaboration with the HCPF and Regional Accountable Entities (RAEs). If you are interested in participating and would like to sign up, you may do so here.

These focus groups are limited to 25 attendees. The first 25 attendees to register in each session using the link above will receive a formal invitation with additional event details. After 25 registrations per session have been reached, a waitlist will be started for each session. Those on the waitlist will receive email notification of their waitlist status and will also be notified by email if seats become available.

If you have questions about registering, please contact Allison Faeder.

The Department of Health and Human Services (HHS) and the Department of Labor have new, free informational resources to inform Americans of their rights under law on coverage for mental health benefits.

“The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA or Parity Law) requires most health plans or health insurers that offer coverage for mental health conditions or substance use disorders to make these benefits comparable to those offered for medical and surgical benefits. This means that deductibles, copays, out-of-pocket maximums, and treatment limitations for mental health or substance use disorders must not be more restrictive than corresponding requirements or parameters offered for medical and surgical benefits.” Read more here.

We recently began a partnership with DarioHealth Corp (Dario), a leader in the global digital therapeutics market to provide digital chronic condition management solution for our Health First Colorado members. We selected Dario to help improve the health of members living with diabetes, hypertension, weight management and behavioral health needs through their person-centric and integrated chronic condition platform. The addition of Dario’s digital solutions, including medical devices and personalized digital and human coaching will enhance our existing diabetes and condition management programming and interventions by providing members with a comprehensive array of condition management education and tools to help them better manage and engage in their health care.

To begin, the program will be only offered to a small number of eligible members. Please contact Ana Brown-Cohen, director of health programs and Jamie Zajac, manager of care management if you have questions.

We have a new credentialing process for organizational providers (including integrated care clinics) who wish to use unlicensed clinicians to render clinical services. This was developed to respond to the behavioral health workforce shortage. Our greatest priority is to maintain a high clinical standard of care for our members; our updated policies will help ensure that unlicensed providers within mental health organizations and integrated care settings are receiving appropriate supervision and oversight, with the goal of excellent patient care that also supports expanding the workforce pipeline.

If you are interested, please complete a clinical application. Once received, we will schedule a site visit with our staff. You will then be credentialed individually to allow the use of unlicensed clinicians. We are no longer requiring providers to have an OBH clinic designation and will not require providers to obtain a BHE designation.

Unlicensed providers (supervised by a licensed clinician) can include the following:

Bachelor’s level staff functioning as case managers, community outreach staff, and/or peers
Master’s level interns
Master’s pre-licensed clinicians
Licensed clinicians not yet validated with Medicaid and/or credentialed with Colorado Access

If you have any questions, please contact our provider network services team at providernetworkservices@coaccess.com.