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September 1, 2009 Notice

September 1, 2009 Provider Reimbursement Changes

 

Click here to read the complete notice.

 

This notice includes changes to adjust reimbursements to match appropriated spending authority for FY 2009-10 for various Medicaid payments.  To maintain access for clients while remaining within the Colorado Medicaid Program's spending authority, the Department isproposing the following:

  • Reducing provider reimbursement rates for most fee-for-service benefits by one-and-one-half percent (1.5%)
  • Reduce provider reimbursement rates by one-and-one-half percent (1.5%)
  • Reduce Federally Qualified Health Center (FQHC) reimbursement rates
  • Change two pricing methodologies used to determine reimbursement for covered fee-for-service outpatient drugs
  • Impose a cap on the amount of non-medical transportation a client enrolled in a home and community-based services waiver program can receive per week
  • Suspend the supplemental Medicaid payment made to qualified rural hospital providers and to qualified hospital providers that provide services to low-income populations
  • Suspend the supplemental Inpatient Hospital Payment for Health Care Services to hospitals that provide primary care services to low-income clients
  • Suspend the Urban Safety Net Provider Payment for inpatient hospital services to Medicaid clients
  • Reduce the Pediatric Major Teaching Hospital Payment
  • Reduce the Commission on Family Residency Training Program payments and State University Teaching Hospital payments by 10%

 

Additionally, Effective October 1, 2009, the Department will not provide additional reimbursement to hospitals for "Serious Reportable Events," certain conditions acquired during a hospital stay.

 

The following items were included in the public notice, but have been delayed until further notice.

  • Reduce provider per diem reimbursement rates to nursing facilities by one-and-one-half percent (1.5%)
  • Impose a cap on the amount of personal care and homemaker services a client enrolled in a home and community-based services waiver program can receive each day