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CCT Brochure - Updated 2016
Transition Referral Information Form
Department staff have the ability to verify the social security number of clients who are submitting a HUD application, but do not have a social security card. You can learn about the process in the DAL SSN verification form and in the SSN verification form.
The Department of Health Care Policy and Financing (HCPF) works in partnership with the State of Colorado Division of Housing to administer CCT. The program is Colorado’s version of the federal grant program, "Money Follows the Person." The program allows Medicaid funding to follow a person from an institutional setting to housing in the community. The goal of CCT is to move persons with disabilities out of nursing homes and other long term care and into the community.
For more information including application forms, guidance, and training, please visit the Division of Housing website or contact Kyra Montgomery at 303-864-7831 or Kyra.Montgomery@state.co.us.
More information about CCT available:
Under Provider Training and Provider Resources and Program Information
The following forms are for HCBS Service Providers who experience a critical incident involving a client enrolled under the following waiver programs, Brain Injury, Children's HCBS, Children with Autism, Consumer Directed Care, Elderly, Blind and Disabled, and Community Mental Health Supports, and need to report the critical incident to the SEP Agency Case Manager.
Please print the relevant questionnaire from the list below and enter all requested information. All questions must be answered in order to make a Prior Authorization Request (PAR) determination. Unless another address is specified on the form, mail the completed the form and the completed PAR to:
ColoradoPAR Provider Line
eQHealth Solutions Customer Service
888-801-9355 (toll free phone)
ColoradoPAR Provider Fax
eQHealth Solutions Fax Line
Additional information and ongoing updates can be found on ColoradoPAR.com or the Department’s Website.
In order to demonstrate sound stewardship of state resources and ensure that Medicaid members have access to and receive appropriate care, the Department sets reasonable limits on the type and amount of durable medical equipment and supplies that may be obtained without a prior authorization (PA).
In 2016, from September through December, the Department posted recommendations made by the Colorado Association for Medical Equipment Services (CAMES). They were primarily in regards to unit limits and the need or lack thereof for PA. During the posted time span, Stakeholder feedback was requested and responses were received. The Department will now review both CAMES’s recommendations and the received Stakeholder feedback. Once the review is complete, any alterations to the current policy will be publish with a future effective date.
For any questions regarding this review, please email: DMEPOS.BMReview@state.co.us.
For a list of the codes reviewed, please reference the DMEPOS Billing Manual.
State of Colorado Medical Assistance Program state plan for Medication Therapy Counseling, Supplement to Attachment 3.1-A, section 6.d.
The PDL is developed based on safety, effectiveness, and clinical outcomes from classes of medications where there are multiple drug alternatives available and supplemental rebates from drug companies, allowing Colorado the ability to provide medications at the lowest possible costs.
Please visit the Pharmacy and Therapeutics (P&T) Committee page for more information.
Preferred Drug List Drug Class Announcements are sent via email at least 45 days prior to each P&T Committee Meeting review. Supplemental rebate offers should be submitted to Provider Synergies / Magellan Rx Health here.
Learn about Mail Order Prescriptions for Health First Colorado members.
Health First Colorado (Colorado's Medicaid Program) has established an extensive formulary in order to provide pharmaceutical benefits to Medicaid members. In order for a provider to prescribe a drug that is not on this established list, the provider must receive an approval on a prior authorization request from the Department.
Note: A provider can submit a request either by phone or by fax to Health First Colorado’s Prior Authorization Helpdesk. The Helpdesk phone number is 1-800-424-5725 and the fax number is 1-800-424-5881. It is open 24 hours a day, seven days a week. If the request meets the PA criteria, the medication coverage will be allowed.
Member Appeal Rights
New Hepatitis C Prior Authorization Request Form - Effective October 1, 2016 (Revised May 2017)
The Global Prior Authorization policy was developed to protect the health of Health First Colorado's most vulnerable members. Members who qualify will be exempt for one year from prior authorization requirements for non-preferred drugs. They will also be exempt from prior authorization requirements for non-PDL drugs currently requiring prior authorization. Clients who do not qualify for a Global Prior Authorization may still be eligible for prior authorizations for individual drugs.
Medicaid Covered Drugs for Medicare-Medicaid Eligible Members
The PAR Status Inquiry in the Colorado Medical Assistance Web Portal (Web Portal) allows providers to make PAR status inquiries about all PAR types. Please review the online Training, User Guide, and the Help feature for additional information.
Submit all PARs to the appropriate Authorizing Agency listed in Appendix D of the Billing Manuals Appendices section.
For more provider enrollment instructions and information, please go to the Provider Enrollment web page.