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June 10, 2009 Notice
June 10, 2009 - FY 2008-09 and FY 2009-10 Provider Reimbursement Changes
Click here to read the complete notice.
This notice includes changes to adjust reimbursements to match appropriated pending authority for FY 2008-09 and FY 2009-10 for various Medicaid and Disproportionate Share Hospital payments:
- Effective July 1, 2009, in an effort to reduce expenditures for the Colorado Medicaid program, it is the intent of the Department to reduce provider reimbursement rates for most fee-for-service benefits by up to two percent (2.0%).
- Effective July 1, 2009, the Department is planning targeted provider rate cuts, which will represent a rate reduction that will achieve a two percent (2%) reduction in total expenditure for Home Health, Private Duty Nursing and Home and Community Based Services (HCBS) providers.
- Effective July 1, 2009, the Home and Community Based Services (HCBS) Developmentally Disabled Services (DD), Supported Living Services (SLS), Children's Extensive Support (CES), and Children's Habilitation Residential Program (CHRP) waivers will implement statewide standardized rates.
- Effective July 1, 2009, it is the intent of the Department to submit a State Plan Amendment (SPA) to change the methodology for calculating inpatient hospital base rates for providers participating in Medicaid.
- Effective October 1, 2009, it is the intent of the Department to submit a SPA to change inpatient hospital reimbursement for Serious Reportable Events.
- Effective July 1, 2009, it is the intent of the Department to submit a SPA to change the methodology for calculating outpatient hospital reimbursement to out of state hospitals, including those out of state hospitals that are border state hospitals.
- Effective July 1, 2009, it is the intent of the Department to submit a SPA changing two pricing methodologies used to determine reimbursement for covered fee-for-service outpatient drugs.
- Effective July 1, 2009, it is the intent of the Department to submit a SPA to adjust the method of reimbursing nursing facilities under the Colorado Medicaid program as directed by Senate Bill 09-263.
- Effective June 15, 2009, it is the intent of the Department to submit a SPA to modify the supplemental Medicaid payment to qualified rural hospital providers and to qualified hospital providers that provide services to low-income populations.
- Effective June 15, 2009, and July 1, 2009 the Department proposes to submit a SPA to adjust the FY 2008-09 and FY 2009-10 annual total expenditures, and if necessary, any prior fiscal year amounts, for various Disproportionate Share Hospital (DSH) payments.
- Effective July 1, 2009, the Department proposes to submit three SPAs to modify the Supplemental Medicaid payments for Outpatient Hospital, Nursing Facility and Home Health Agency services.
- Effective July 1, 2009, the Department proposes to submit a SPA to modify the supplemental Medicaid payment to Denver Health Medical Center and other qualified hospital providers that operate primary care clinics and provide primary care services to low-income populations.
- Effective July 1, 2009, the Department proposes to submit a SPA to modify the supplemental Medicaid payment to qualified rural hospital providers and to qualified hospital providers that provide services to low-income populations.
- Effective July 1, 2009, the Department, for the purpose of additional reimbursement, proposes to submit a SPA to receive a federal match under the DSH allocation for the Primary Care Fund payment to Denver Health Medical Center.
- Effective July 1, 2009, the Department proposes to submit a SPA or a proposal to the federal Division of Cost Allocation to allow Medicaid School Based Administrative Claiming.
- Effective July 1, 2009, the Department proposes to submit a SPA to implement portions of the Health Care Affordability Act of 2009, House Bill 09-1293. The Department is authorized to collect inpatient and an outpatient hospital provider fees for the purpose of obtaining federal financial participation for the state's medical assistance programs. Provider fees shall be used to increase reimbursements to hospitals; to increase the number of people covered by medical assistance programs; and to pay for administrative costs related to the fee and program expansions.