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FY 2006-07 Footnote Reports
Footnotes 37a, 40a, and 42a are from HB 06-1369 "Concerning a Supplemental Appropriation to the Department of Health Care Policy and Financing" and impact FY 2005-06. All other footnotes are from HB 06-1385 Long Appropriations Bill and impact FY 2006-07.
| Footnote 20 | Monthly Report of Expenditure and Caseload for Medicaid and CBHP | |||||||||||||||||||||||||||||||||||||||
From HB 06-1385 Long Appropriations Bill:
Department of Health Care Policy and Financing, Executive Director's Office - The Department is requested to submit monthly Medicaid expenditure and caseload reports on the Medical Services Premiums budget to the Joint Budget Committee, by the third Monday of each month. The Department is requested to include in the report the managed care organization caseload by aid category. The Department is also requested to provide caseload and expenditure data for the Children's Basic Health Plan within the monthly report.
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| Footnote 20a | Third Party Collections and State Auditor's Recommendations | |||||||||||||||||||||||||||||||||||||||
From HB 06-1385 Long Appropriations Bill:
Department of Health Care Policy and Financing, Executive Director's Office -- It is the intent of the General Assembly that the Department comply with federal regulations that the Medicaid program be the payer of last resort to the fullest extent possible (42 CFR 433.138 and 42 CFR 433.139). If the State Auditor finds that the Department is deficient in collecting from third party payers, the Department is authorized to seek federal waiver authority to pay providers first and then seek reimbursement from the obligated third party payer. The Department is requested to submit a report to the Joint Budget Committee by November 1, 2006, on the effectiveness of its third party collections and how the Department plans to address any recommendations contained in the State Auditor's review of this issue. The Department is also requested to include a cost benefit analysis of when it is in the state's interest to pursue third party recovery.
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| Footnote 20b | Status Report on Various Legislation | |||||||||||||||||||||||||||||||||||||||
From HB 06-1385 Long Appropriations Bill:
Department of Health Care Policy and Financing, Executive Director's Office -- The Department is requested to provide a status report on the implementation schedules and anticipated FY 2006-07 fiscal impact for the following legislation: S.B. 04-177, H.B. 05-1015, H.B. 05-1066, H.B. 05-1131, and H.B. 05-1243. This report is requested to be submitted to the majority and minority leadership in each house of the General Assembly and to the Joint Budget Committee by no later than August 1, 2006.
Exhibit A: Fiscal Impact Summary Exhibit B: Medical Assistance Program Bulletin - March 2006
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| Footnote 22 | Rate Disparity and Shortfalls for Physician and Acute Care Providers | |||||||||||||||||||||||||||||||||||||||
From HB 06-1385 Long Appropriations Bill:
Department of Health Care Policy and Financing, Executive Director's Office, Primary Care Provider Rate Task Force and Study -- The Department is requested to work with the provider community to examine any issues of rate disparity and rate shortfalls for physician and acute care providers. The Department is requested to report on its preliminary findings by November 1, 2006, and its final analysis by November 1, 2007. The Department's appropriation contains $58,000 total funds for the expenses of any task force that the Department may assemble and for temporary staffing costs for conducting such a study.
Footnote #22 Report - Preliminary Findings
Footnote #22 Report - Final Analysis (The final analysis report was also requested for footnote 24 of SB 07-239 Long Appropriations Bill.)
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| Footnote 23 | Managed Care Organizations' Capitation Rates | |||||||||||||||||||||||||||||||||||||||
From HB 06-1385 Long Appropriations Bill:
Department of Health Care Policy and Financing, Medical Services Premiums - The Department is requested to submit a report on the managed care organizations' capitation rates for each population and the estimated blended rate for each aid category in effect for FY 2006-07 to the Joint Budget Committee by July 25, 2006. The Department is requested to include in the report a copy of each managed care organization's certification that the reimbursement rates are sufficient to assure the financial stability of the managed care organization with respect to delivery of services to the Medicaid recipients covered in their contract pursuant to section 26-4-114 (2) (k), C.R.S.
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| Footnote 26 | Rules on Physician, Dental, EPSDT, Lab and X-Ray, and Durable Medical Equipment Reimbursement Rate Increases | |||||||||||||||||||||||||||||||||||||||
From HB 06-1385 Long Appropriations Bill:
Department of Health Care Policy and Financing, Medical Services Premiums -- The calculations for this line item include $9,917,925 total funds for a 3.25 percent reimbursement rate increase for primary care providers beginning July 1, 2006. It is the intent of the General Assembly that the Medical Services Board adopt rules to increase reimbursement rates for provider codes paid from the physician, dental, Early and Periodic Screening, Diagnosis and Treatment, lab and x-ray, and durable medical equipment services categories. The Department is requested to provide a report to the Joint Budget Committee by August 1, 2006, on the status of the rules adopted by the Medical Services Board regarding this reimbursement rate increase.
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| Footnote 27 | Rules on Inpatient Hospital Services Reimbursement Rate Increases | |||||||||||||||||||||||||||||||||||||||
From HB 06-1385 Long Appropriations Bill:
Department of Health Care Policy and Financing, Medical Services Premiums -- The calculations for this line item 1 include $11,713,742 total funds for a 3.25 percent rate increase for inpatient hospital services provided to Medicaid clients beginning July 1, 2006. It is the intent of the General Assembly that the Medical Services Board adopt rules that increase each individual hospital's Medicaid reimbursement rate by 3.25 percent for inpatient hospital services provided to Medicaid clients. The Department is also requested to provide a report to the Joint Budget Committee by August 1, 2006, on the status of the rules adopted by the Medical Services Board regarding this rate increase.
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| Footnote 28 | Rules on Home and Community-Based Waiver, Private Duty Nursing, and Home Health Services Reimbursement Rate Increases | |||||||||||||||||||||||||||||||||||||||
From HB 06-1385 Long Appropriations Bill:
Department of Health Care Policy and Financing, Medical Services Premiums -- The calculations for this line item include $4,138,750 for rate increase for home- and community-based waiver services, private duty nursing services, and home health services beginning April 1, 2007. It is the intent of the General Assembly that the Medical Services Board adopt rules to provide the following rate increases:
The Department is requested to report to the Joint Budget Committee by June 1, 2007, the rate plan that has been adopted by the Medical Services Board.
Enclosure: Medical Assistance Program Bulletin - April 2007
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| Footnote 29 | Quarterly Reports of the Medicare Modernization Act of 2003 | |||||||||||||||||||||||||||||||||||||||
From HB 08-1385 Long Appropriations Bill:
Department of Health Care Policy and Financing, Medical Services Premiums - Beginning in January 2006, individuals fully eligible for the Medicare and Medicaid coverage will receive their drug benefits through the Medicare Modernization Act of 2003, Part D Drug Benefit Program. While this program is anticipated to create prescription drug savings in the state's Medicaid program, these savings will be reduced by the mandatory State contribution to the federal government. The Department is requested to provide the Joint Budget Committee with quarterly reports regarding the calculations for the mandatory state Contribution payment to the federal government for the Medicare Modernization Act of 2003. The reports should contain an estimate of how the state contribution payment compares to the savings estimate of transferring the prescription drug benefit from the Medicaid program to the Medicare program.
Footnote #29 Report - 1st quarter
Footnote #29 Report - 2nd quarter
Footnote #29 Report - 3rd quarter
Footnote #29 Report - 4th quarter
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| Footnote 30 | Hospital Disbursement from the Safety Net Provider Payment Line Item | |||||||||||||||||||||||||||||||||||||||
From HB 06-1385 Long Appropriations Bill:
Department Health Care Policy and Financing, Indigent Care Program, Safety Net Provider Payments -- The Department is requested to submit a report by February 1, 2007, to the Joint Budget Committee, estimating the disbursement to each hospital from the Safety Net Provider Payment line item for FY 2006-07.
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| Footnote 33 | Changes to the Benefit Structure or Eligibility Criteria for the Old Age Pension Program | |||||||||||||||||||||||||||||||||||||||
From HB 06-1385 Long Appropriations Bill:
Department of Health Care Policy and Financing, Other Medical Services, Services for 5,989 Old Age Pension State Medical Program clients at an average cost of $2,381.48 -- The Department is requested to submit a report by November 1, 2006, recommending changes to the benefit structure or eligibility criteria for the Old Age Pension State Medical Program in order to stay within the appropriation limit of $13,286,483 for FY 2007-08. The report should include the most recent five-year expenditure history for the different medical services categories used by this population. In addition, the report should include a five-year forecast for the caseload and costs of this program if benefits are not reduced.
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| Footnote 34 | SB 97-101 Public School Health Service Program | |||||||||||||||||||||||||||||||||||||||
From HB 06-1385 Long Appropriations Bill:
Department of Health Care Policy and Financing, Other Medical Services, S.B. 97-101 Public School Health Services -- The Department is requested to submit a report by November 1 of each year to the Joint Budget Committee on the services that receive reimbursement from the federal government under S.B. 97-101 public school health service program. The report should include information on the type of services, how those services meet the definition of medical necessity, and the total amount of federal dollars that was distributed to each school under the program. The report should also include information on how many children were served by the program.
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| Footnote 37a | Rules on Inpatient Hospital Services Reimbursement Rate Increases | |||||||||||||||||||||||||||||||||||||||
From HB 06-1369 "Concerning a Supplemental Appropriation to the Department of Health Care Policy and Financing."
Department of Health Care Policy and Financing, Medical Service Premiums -- the calculations for this line item include $831,000 total funds for a 1.0 percent rate increase for inpatient hospital services provided to Medicaid clients. It is the intent of the General Assembly that the Medical Services Board adopt rules that increase each individual hospital's Medicaid reimbursement rate by 1.0 percent for inpatient hospital services provided to Medicaid clients. The Department is also requested to provide a report to the Joint Budget Committee by June 1, 2006, on the status of the rules adopted by the Medical Services Board regarding this rate increase.
Attachment: Medical Assistance Program Bulletin - May 2006
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| Footnote 40a | Rules on Long-Term Care Community Providers Reimbursement Rate Increases | |||||||||||||||||||||||||||||||||||||||
From HB 06-1369 "Concerning a Supplemental Appropriation to the Department of Health Care Policy and Financing."
Department of Health Care Policy and Financing, Medical Services Premiums -- the calculations for this line item include $5,100,000 total funds for rate increases for long-term care community providers. It is the intent of the general assembly that the Department increase rates as follows:
The Department is requested to report to the Joint Budget Committee by June 1, 2006 the rate plan that has been adopted by the Medical Services Board.
Attachment: Medical Assistance Program Bulletin - May 2006
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| Footnote 42a | Rules on Durable Medical Equipment Reimbursement Rate Increases | |||||||||||||||||||||||||||||||||||||||
From HB 06-1369 "Concerning a Supplemental Appropriation to the Department of Health Care Policy and Financing."
Department of Health Care Policy and Financing, Medical Service Premiums -- the calculations for this line item includes $309,000 total funds for a 2.0 percent rate increase for durable medical equipment rates. It is the intent of the General Assembly that the Medical Services Board adopt rules that increase each durable medical equipment rates by 2.0 percent. The Department is also requested to provide a report to the Joint Budget Committee by June 1, 2006, on the status of the rules adopted by the Medical Services Board regarding this rate increase.
Attachment: Medical Assistance Program Bulletin - May 2006
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