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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.
Denver Housing Authority (DHA) has Section 8 vouchers for Denver residents who are CCT participants. Here are the eligibility criteria:
Denver Housing Authority CCT Housing Packet
Under Provider Training and Provider Information and Program Information
The following forms are for HCBS Service Providers and SEP Agency Case Managers 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.
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 Health First Colorado members have access to and receive appropriate care, the Department sets reasonable limits on the type and amount of durable medical equipment (DME), prosthetics, orthotics, and supplies that may be obtained without a prior authorization. The Department has been reviewing this criteria with the help of the Colorado Association for Medical Equipment Services (CAMES) and would like your feedback prior to our final decisions.
Unit limits are not absolute - If a member requires units over the given limits a Prior Authorization Request (PAR) can be submitted with an explanation of why the quantity of units are medically necessary. The new claims system (MMIS) will reimburse over the stated limits only with an approved PAR.
The CAMES recommendations are not a change or update to existing DMEPOS policies or coverages. Any changes resulting from this review will be communicated and published at a later date.
For administrative ease, the codes that CAMES has made recommendations for have been broken into three (3) sections. Each section will be posted a month apart beginning September 1, 2016.
Section 1: Disposable Supplies, Wheelchairs, Bedroom Equipment, Bathroom Equipment, and Complex Rehabilitation Technology.
Section 2: All other DME, all other Supplies, Upper Body Orthotics, and Orthotic Repair.
Please email comments to: DMEPOS.BMReview@state.co.us***Please include the section in the subject line (I.e. “Section 2”)***
For a complete list of all 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.
The Supplemental Rebate Agreement template is in MS Word format and may be modified to facilitate the submission of supplemental rebate offers.
Health First Colorado (Colorado's Medicaid Program) has established an extensive formulary in order to provide pharmaceutical benefits to Medicaid clients. 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 1-800-365-4944. It is open 24 hours a day, seven days a week. If the request meets the PA criteria, the medication coverage will be allowed.
Client Appeals Rights
Hepatitis C Prior Authorization Request Form - Effective October 1, 2016
NOTE: Please use the two (2) page PA form with effective date 10/1/16 for all requests beginning 10/1/16.
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.
Synagis® Prior Authorization Request (PAR) Form