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OCTOBER 2024 |
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At Colorado Access, we are committed to caring for you and your success as you serve our members. Our monthly Provider Update highlights essential information and resources to support you as a contracted provider with us. |
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Behavioral Health/Substance Use Disorder (SUD) |
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Changes to SUD Confidentiality Regulations
This year, the U.S. Department of Health and Human Services (HHS) issued a final rule to enhance care coordination for people with SUD by allowing great information-sharing flexibilities. Read more here. |
Fourth Annual Substance Use Disorder Stakeholder Forum
This year’s Department of Health Care Policy and Financing (HCPF) forum will be held virtually on Wednesday, October 16, at 5:00 p.m. HCPF will review the Annual Report for Demonstration Year 3 and give updates about the 1115 Waiver “Expanding the Substance Use Disorder Continuum of Care.” Click here to register to attend. If you have any questions or feedback about gaps in the SUD continuum of services, please email them to the 1115 inbox. |
Safety Net Provider Forum
Many changes will be coming for the behavioral health safety net in Colorado. Join HCPF on Friday, October 25, from 10:00 a.m. to 11:00 a.m. for a Safety Net Provider Forum. Click here to learn more and to register to attend. If you have any questions about safety net providers, please email hcpf_safetynetforum@state.co.us. If you have any questions about training and technical assistance, please email Health Management Associates at safetynettta@healthmanagement.com. |
988 Suicide & Crisis Lifeline Update
The lifeline has begun routing cellphone calls to 988 contact centers based on the caller's approximate location instead of area code, known as "routing.” Read more here.
The Colorado Behavioral Health Administration (BHA) and 988 Crisis Hotline Enterprise are launching a campaign to promote the 988 Colorado Mental Health Line. The crisis line connects callers to trained crisis specialists who offer mental health, emotional, and substance use support through calls, texts, and chats.
Although the state is transitioning from Colorado Crisis Services to 988, the same contact center manages both services, and the walk-in centers will not be impacted. Colorado Crisis Services will continue to be available.
Learn more on the new 988 website. If you have questions, read the 988 frequently asked questions page or email the BHA and 988 board team at 988colorado@state.co.us. |
End Date for Allowing First Position Modifiers on Claims
HCPF had issued guidance on removing all required first position modifiers to indicate State Plan or "B3" services in the State Behavioral Health Services (SBHS) Billing Manual, as of January 1, 2024. HCPF, RAEs, and Denver Health Medicaid Choice (DHMC) have allowed these modifiers on claims while providers updated electronic health records (EHRs), billing systems, and other workflows, but claims for services provided on or after January 1, 2025, that include State Plan or “B3” modifiers shall be denied by RAEs. EHRs and billing systems should reflect correct coding as detailed in the SBHS Billing Manual.
If you have any questions, please email your program specialist and copy hcpf_bhcoding@state.co.us. |
Increasing Access to Supportive Housing Services
HCPF has a distinct billable pathway to supportive housing providers to support expanding these services. The coding pages in the SBHS Billing Manual for H0043 (supportive housing, per diem) and H0044 (supportive housing per month) have been revised to reflect the scope of the benefit. To qualify for full reimbursement of these codes, you must get a letter from the Colorado Department of Local Affairs Division of Housing (DOLA/DOH), which identifies your agency as a supportive housing provider overseeing an allocation of supportive housing resources/vouchers. You should also enroll as a supportive housing provider (provider type 89 – community support services provider with specialty 208 – supportive housing provider). Learn more here. |
Physical Health
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Meeting LGBTIA+ Health Care Needs in Medicaid
The Centers for Health Care Strategies (CHS) has an infographic and brief about how Medicaid agencies can support high-quality health care for LGBTQ+ people's unique health challenges. |
Free COVID-19 Tests
Households across the U.S. can order up to four more free COVID-19 tests from the federal government. Read more here and request tests now from covidtests.org. |
Updated COVID-19 Vaccines
The Centers for Disease Control and Prevention (CDC) recommends that everyone six months old and older get an updated COVID-19 vaccine. This year, multiple options from Moderna and Pfizer target the KP.2 variant, which has been dominant in the U.S. since May. A Novavax vaccine is also available, but it targets JN.1, which has been circulating at lesser rates than a few months ago. |
2024-2025 Immunization Rates
Click here to read the updated immunization rates from HCPF. |
COVID-19 Reimbursement Rates
The COVID-19 vaccine administration rate will change for dates of service on or after October 1, 2024. The vaccine will be reimbursed at the same rate as all other vaccines. The Current Procedural Terminology (CPT) code 90480 reimbursement rate will change to $21.17.
All vaccine reimbursement rates were updated on July 1, 2024. Click here to read the immunization fee schedule.
Coverage and rates are the same for Child Health Plan Plus (CHP+) members.
If you have any questions about vaccine policy, email Christina Winship at christina.winship@state.co.us. For help with claims and billing, contact the Provider Services Call Center. |
News From HCPF |
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Colorado Medicaid eConsult Update
All Health First Colorado (Colorado’s Medicaid program) providers can access a free and secure statewide electronic consultation (eConsult) platform through coloradomedicaideconsult.com. eConsults frequently eliminate the need for in-person member referrals by allowing primary care medical providers (PCMPs) to communicate electronically with specialty providers. A policy update from HCPF is coming to allow for specialty-to-specialty eConsults.
More Information
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Resources for Behavioral Health Providers
The new HCPF training library page has recordings of live training, links to pre-recorded training, and slides from each training. HCPF also has monthly office hours during which you can ask experts your questions. Click here for frequently asked questions and answers. |
Primary Care Medical Provider (PCMP) Network Feedback
We have several upcoming opportunities for the primary care medical provider (PCMP) network to share feedback on the administrative payment models under ACC Phase III. We will review HCPF-identified priority areas, provide comprehensive overviews of potential metrics, discuss complex member populations and care coordination objectives, and encourage you to share your insights and suggestions.
All sessions will be held from 12:00 p.m. to 1:30 p.m. online:
We recommend that family medicine providers attend both the pediatric and adult sessions.
Your feedback and insights help us refine these models to ensure alignment with our regional goals. Click here to register. If you have any questions, please contact our payment reform team. |
New From Colorado Access |
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New Renewal Digital Engagement Program
On October 1, 2024, we launched a new digital engagement program to help eligible members keep their Health First Colorado or Child Health Plan Plus (CHP+) coverage and prevent them from losing their benefits or having a gap in services. The program includes a one-time automated phone call reminding members that their renewal deadline is approaching and gives directions on submitting their renewal packet. Members who cannot be properly integrated into the automated call program are sent a direct mailer with the same information.
If Colorado Access members have questions about their renewal, please direct them to healthfirstcolorado.com/renewals and co.gov/peak. |
Upcoming Flu/Respiratory Digital Engagement Program
This program, which runs from October to February, informs Health First Colorado and CHP+ members about the flu, including tips on flu prevention and reminders that flu, respiratory syncytial virus (RSV), and COVID-19 all have the same peak season. |
One-Time Dental Visit Reminder
This one-time SMS program will run in October to remind Health First Colorado and CHP+ members who are overdue for a dental visit to see their dentist and connect with DentaQuest. |
Checking Credentialing Status
You can now check the status of those approved for credentialing at your clinic. Log into the provider portal and click “Reports” to get a list of credentialed providers under the clinic tax ID number and the approval/effective date. If you have any questions about credentialing, please email credentialing@coaccess.com. |
Intent to Award Notice to Colorado Access
HCPF has issued an “Intent to Award” notice to Colorado Access to serve as the RAE for Region 4 in Phase III of Health First Colorado’s Accountable Care Collaborative. This notice was subject to a protest period that expired on September 27, 2024. New contracts will take effect July 1, 2025. Learn more here. |
Health Care News Highlights |
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