At Colorado Access, caring for you and your success is our top priority as you serve our members. This monthly Provider Update serves as a highlight of important information and resources to help you as a contracted provider with us.
Public Health Emergency (PHE) Update
The PHE ends May 11, 2023. The renewal process for the more than 1.75 million people covered by either Health First Colorado (Colorado’s Medicaid program) or Child Health Plan Plus (CHP+) starts in May. The Colorado Department of Health Care Policy and Financing (HCPF) estimates that 30% of enrolled people will not need to take any action to remain covered, while the other 70% will need to submit eligibility verification.
HCPF also estimates that more than 325,000 people will no longer qualify for Health First Colorado and CHP+ coverage. People who no longer qualify can apply for insurance through the state’s official marketplace, Connect for Health Colorado, online or by calling their customer service line at 855-752-6749.
As more updates become available, we will continue to share what this means for you and for our members.
Emergency Additional Supplemental Nutrition Assistance Program (SNAP) Benefits Ending
During the COVID-19 pandemic, SNAP benefits were temporarily raised for everyone, which allowed every household to get the maximum amount of money for food they were able to receive, depending on their household size and circumstances. Recent congressional action ended this emergency allotment in February 2023. This means that all SNAP recipients (more than 290,000 households and 554,000 individuals in Colorado) will get less benefit dollars starting in March 2023. Click here to view the messaging toolkit to help share information about the end of SNAP emergency allotment benefits.
Benefit Update: Multi-User Breast Pump Loaner
As of January 1, when billing for multi-user breast pumps, use procedure code E0604 with modifier RR.
The multi-user breast pump is a continuous rental item that will not be converted to purchase, but it may be rented for up to two years. Prior authorization requests (PARs) are required for this item. Prescriptions should include information on why the member cannot use a single-user pump. You are also required to supply members you prescribe this item the necessary material and training on appropriate cleaning, storage, and use.
There must also be a single-user collection kit specifically made for the corresponding pump given to each user. This is not billed separately. If the users need additional accessories and supplies during the usage period, including replacement parts, this should not be billed separately; this is inclusive of the monthly rate.
The Food and Drug Administration (FDA) must approve all rented pumps as a multi-user breast pump. Electric and manual single-user breast pumps are still a covered benefit, and do not need PARs.
Members may get a breast pump as early as their 28th week of pregnancy. Deliveries before 28 weeks qualify for a breast pump immediately following the birth (per Early and Periodic Screening, Diagnostic and Treatment (EPSDT) policy).
If you have any questions, please email Haylee Rodgers at haylee.rodgers@state.co.us.
Register Now for the March Health Cabinet Summit
Join Lt. Gov Primavera, Health Cabinet executive directors, and industry leaders for the Health Cabinet Affordability Summit hosted by HCPF on Wednesday, March 15th from 7:30 a.m. to 10:00 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, and partnering to “Keep Coloradans Covered” after the end of the PHE. Click here to learn more and to register.
Substance Use Disorder (SUD) Provider Forum
HCPF is partnering with the Behavioral Health Administration (BHA) on quarterly joint forums for SUD providers. The 2023 forums will be on the first Wednesday of April, July, and October from 2:00 p.m. to 3:00 p.m. Click here to register for any or all meetings.
Learn more about the SUD benefit here and here. You can also sign up for the monthly newsletter here.
Integrated Behavioral Health Grant
In May 2022, the Colorado General Assembly passed House Bill 22-1302 to support, improve, and expand integrated behavioral health services in Colorado. HCPF received $31 million from allocation of the American Rescue Plan Act (ARPA) funds for integrated behavioral health services in primary care settings. Short-term grant funding will be offered to physical and behavioral health care providers who are expanding access to care and treatment for mental health and SUD using an evidence-based integrated care model.
Applications for funding are due Wednesday, April 26, 2023. Click here to learn more.
Provider Billing Training Sessions
If you submit claims, are new to billing Health First Colorado services, or need a billing refresher course, you are invited to upcoming virtual training sessions for an overview of Health First Colorado billing instructions and procedures.
Upcoming sessions will cover institutional claims (UB-04) and professional claims (CMS 1500), overviews of claim submissions, navigating HCPF’s website, using the provider web portal, and more.
Click here for the schedule and to learn how to register. You can also find more training materials here.
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