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At Colorado Access, caring for you and your success is our top priority as you serve our members. This monthly Provider Update highlights important information and resources to help you as a contracted provider with us.
Public Health Emergency (PHE) Update
The PHE ended on May 11, 2023. Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+) members have returned to normal eligibility renewal processes. Noticing began in March 2023. The redetermination process will take place over 12 months, so not all members will have to renew at the same time. Members will be due for renewal in the calendar month they enrolled.
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Survey: Serious Mental Illness Practice Transformation Project
Mental Health Colorado is developing training and education materials to help providers better serve people with serious mental illnesses, including three brief surveys targeted towards different audiences to fully understand the needs of providers, people with lived experience of illness, and their loved ones. The surveys are open until Friday, June 23rd at 5:00 p.m.
The information they gather will be analyzed, evaluated, and shared over the next month. Your feedback is important. Please share the surveys with your network. If you have any questions or want to get more involved, email Bonnie Brandl at bbrandl@mentalhealthcolorado.org.
Provider Web Portal
The state of Colorado’s Provider Web Portal has moved here. Please make sure to update your bookmarks with the new URL.
You can check member eligibility, complete provider revalidation, and update information on the portal. Click here for a guide on how to use the portal.
Telehealth Coverage Discontinued for Well Child Visits
Telehealth coverage for well child visits was added during the PHE, but this coverage was discontinued on May 11, 2023. You will still be reimbursed for in-person well child visits.
Click here to learn more.
Health First Colorado Directed Payment Fee Schedule
Starting July 1, 2023, Health First Colorado will implement directed payments for certain child and adolescent behavioral health services. We will be sending you a notice of non-material change to your behavioral health fee schedule this month to comply with the directed payments. In addition to implementing directed Medicaid payments, we have applied the directed payments to the CHP+ fee schedule, and increased reimbursement for all CHP+ behavioral health services.
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2023 Health Equity Plan Public Meetings
The Department of Health Care Policy and Financing (HCPF) has multiple health equity plan public meetings coming up. These meetings are for providers, members, and community stakeholders to learn more about the plan and give input and feedback.
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For Opioid Treatment Providers: Take-Home Buprenorphine
As of May 1, 2023, a new policy began where opioid treatment providers (OTPs) may dispense up to a seven-day supply of take-home oral buprenorphine and buprenorphine combination physician-administered drugs (PADs) to Health First Colorado members.
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Change to Adult Dental Benefit Limit for Health First Colorado
Starting July 1, 2023, Health First Colorado will remove the adult and Intellectual and Developmental Disabilities (IDD) dental benefit maximum. Members were previously limited to $1,500 a year, but there is no limit now. All services will be covered at 100%. This does not affect frequency; those limits remain the same.
CHP+ Breast Pump/Lactation Benefit
As of July 1, 2022, CHP+ offered by Colorado Access has a benefit that covers breast pumps for prenatal and postpartum CHP+ members. If you are a Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) provider, you may now bill us as the primary payer for manual and/or single user electric breastfeeding pumps.
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Family Planning Updates
Starting July 1, 2023, members in the emergency medical services (EMS) and reproductive health care program category are eligible to get family planning-related services for a $0 copay, which will expand the services this population is eligible for.
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Free Screening, Brief Intervention and Referral to Treatment (SBIRT) Training
If you are a Health First Colorado provider, you can get free SBIRT training through a partnership with Peer Assistance Services, Inc. (PAS). This program promotes prevention and early intervention efforts through training (in-person, online, and virtual), technical assistance, and hands-on SBIRT implementation. Learn more here.
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Senate Bill (SB) 21-137 Implementation
SB 21-137, Behavioral Health Recovery Act of 2021, Section 9, will be implemented July 1, 2023. The full bill was signed into law in Colorado in 2021. It requires that the Department of Health Care Policy and Financing (HCPF) get a second medical necessity review for residential or inpatient substance use disorder (SUD) requests. HCPF’s utilization management vendor, Kepro®, will perform the second SUD reviews.
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411 Behavioral Health Audit
The annual state mandated 411 behavioral health audit has been completed. A total of 1233 claims across the state of Colorado were reviewed. Documentation was audited across three behavioral health service categories – inpatient, residential and outpatient psychotherapy. Providers involved in this audit should expect to receive results letters in July 2023. In the meantime, the COA Compliance Department is working hard on collaborating internally to incorporate more education and training opportunities to help support providers.
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