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