State Achieves Benchmarks for Medical Assistance Applications Processing
Decades-Old Lawsuit is Resolved
FOR IMMEDIATE RELEASE
July 26, 2016
Denver, CO - The Department of Health Care Policy and Financing (Department) announced today the dismissal of a lawsuit brought against the Department more than a decade ago. The lawsuit was brought by advocates in 2004 over the time it was taking the Department to process applications for medical assistance. The resolution comes after the Department and its eligibility partners successfully met benchmarks outlined in a 2011 settlement for processing new medical assistance applications and completing redeterminations, which establish whether individuals currently receiving medical assistance are still eligible to receive benefits.
"We have come a long way to improve our application processing by making strategic investments in technology and improving eligibility partner business processes," said Susan E. Birch MBA, BSN, RN, Executive Director. "We have modernized our systems - which once required paper applications - to today where the majority of applications can be completed online. Most applications receive an answer in real time for medical assistance programs. Our county partners have made significant improvements in their business processes to help Coloradans get the services they need, faster."
The 2011 settlement required the state to process new applications and complete redeterminations within 45 days, 95 percent of the time for at least 12 consecutive months. The Department has met this standard for the past 16 months for redeterminations and two years for new applications. The majority of new medical assistance applications completed online now receive real time eligibility determinations. Applications that do not receive immediate determinations generally require additional verifications, including those that require a disability determination, and are usually processed within two weeks. Colorado has made improvements to the medical assistance redetermination process to make it less burdensome to complete and more efficient to process. For example, Health First Colorado (Colorado's Medicaid Program) members receive a pre-populated form with their current information on file. If their information did not change, members no longer need to take action for their coverage to continue.
Applying for medical assistance programs, like Health First Colorado and Child Health Plan Plus (CHP+), can be done online, over the phone, by mail or in person at numerous assistance sites statewide. Children who qualify have 12 month continuous eligibility for medical assistance programs, and adult coverage is month to month as long as income and other requirements are met.
About the Colorado Department of Health Care Policy and Financing
The Department administers Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus as well as a variety of other programs for low income Coloradans who qualify. For more information about the Department, visit Colorado.gov/HCPF.