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We have partnered with the Centers for Medicare & Medicaid Services (CMS) to implement a new program designed to better coordinate care for Coloradans who are eligible for both Medicare and regular Colorado Medicaid. The ACC: Medicare-Medicaid Program will coordinate physical, behavioral and social health needs for Medicare-Medicaid members in an effort to improve their health care experiences. Members on this program can remain with their current providers and continue receiving the same benefits and services. This initiative builds on the infrastructure, resources and provider network found in the Accountable Care Collaborative (ACC) Program. This program connects members with providers, community and social services to help meet their needs and improve their health outcomes.
Our Accountable Care Collaborative (ACC): Medicare-Medicaid Program stakeholder meetings provide important updates surrounding this program.
ACC Medicare-Medicaid Member Information
ACC Medicare-Medicaid Stakeholder Provider Training Information
ACC: Medicare-Medicaid Program Overview Training for Advocates and Stakeholders
The purpose of the ACC: Medicare-Medicaid Stakeholder meetings are to provide important program updates and maintain transparent communication between us and the people involved with or affected by this program.
The ACC: Medicare-Medicaid Advisory Subcommittee was formed to advise us on issues related to the implementation of the program.
Stakeholders and participants involved with this committee provide guidance and make recommendations to help improve health, access to care, cost and satisfaction of members and providers in the Accountable Care Collaborative (ACC). These committee meetings are open to the public.
The Department developed a stakeholder Advisory Committee for the purpose of exchanging information and identifying, evaluating and communicating issues related to the Colorado Medicaid Community Behavioral Health Services Program (Behavioral Health Program).
Behavioral Health Quality Improvement Committee ( BQuIC) works on issues involving quality of behavioral health care. The BQuIC meetings are normally held on the fourth Tuesday of every month from 10:00 a.m. to 12:00 p.m. Attendees for this meeting include staff from the Department of Health Care Policy and Financing (Department), Health Services Advisory Group (HSAG), Office of Behavioral Health (OBH), and staff from each of the five Behavioral Health Organizations (BHOs) in Colorado.
Colorado Medicaid established the Benefits Collaborative in 2008, in an effort to define its covered services. The Benefits Collaborative serves as the Department's formal coverage standard development process. Since the Benefits Collaborative aims to produce evidence-based policies guided by best practices, we seek to invite a diverse group of stakeholders - providers, administrators, clients, advocates, policy makers, etc. into the process.
The Children's Disability Advisory Group serves in an advisory capacity to the Department and makes recommendations regarding issues related to benefits for disabled children and youth age 20 and under, provider education interventions, and application of standards.
The Group consists of parents of children with disabilities, representatives from other state agencies, children's advocate and policy organizations, and Early and Periodic Screening, Diagnostic and Treatment (EPSDT) staff.
The Children's Services Steering Committee serves in an advisory capacity to the Department and makes recommendations regarding issues related to benefits for children and youth age 20 and under, provider education interventions and application of standards.
The primary function of this council is to provide guidance and recommendations regarding operational policy and procedural changes to the CCT program and to create solutions to streamline community transitions. The council will analyze barriers for transitions and provide recommendations for improved practices. Additionally, The CCT Advisory Council will provide recommendations for the use of rebalancing funds to the Department of Health Care Policy and Financing. The work of this council will directly inform the implementation of the Colorado’s Olmstead Plan.
The commission's three-year mission is to analyze health care costs and make policy recommendations to the Legislature and the governor for lowering health care costs in the state.
This Forum provides an informal environment for CICP client advocates, participating providers and other stakeholders to exchange ideas, review policies and make recommendations to the Department that address the CICP eligibility process, provider relations, client relations, and other pertinent issues.
The Community First Choice Development and Implementation Council is an advisory group consisting primarily of consumer, family and advocate members. The Council is responsible for working together to provide a set of recommendations to the State on how to proceed with this option.
The Office of Community Living was created by Governor Hickenlooper through an Executive Order in July 2012. The Office will help meet the growing need for long-term services and supports by people with disabilities and aging adults and will be housed in the Department of Health Care Policy and Financing (Department).
The Community Living Advisory Group will consider and recommend changes to the Long-term Services and Supports (LTSS) delivery system. The Advisory Group is working closely with the Colorado Commission on Aging and other planning groups to carry out this work and build on previous discussions and recommendations.
The Drug Utilization Review (DUR) Board serves in an advisory capacity to the Department and makes recommendations regarding issues of drug utilization, provider education interventions, and application of standards. The Board meets once quarterly. The Board consists of nine members appointed by the Executive Director; four physicians, four pharmacists licensed and actively practicing in Colorado, and one non-voting pharmaceutical industry representative.
The DUR Board also determines the prior authorization criteria for drugs with special prescribing guidelines and the prior authorization criteria for non-preferred drugs, those that don't make the Preferred Drug List (PDL).
The Hospital Provider Fee Oversight and Advisory Board is responsible for working with the Department of Health Care Policy and Financing and the Medical Services Board to develop the hospital provider fee model, monitor the implementation of the bill, help with preparation of annual reports on this program, and ensure that the Medicaid and Child Health Plan Plus (CHP+) eligibility expansions are implemented as intended.
The Medical Clean Claims Task Force was created as a result of the passage of House Bill 10-1332, which was signed by the Governor in May of 2010. This bill required the Executive Director of the Department of Health Care Policy and Financing to assemble a group of industry and government representatives to develop a standardized set of payment rules and claim edits to be used by payers and health care providers in Colorado.
The Medical Quality Improvement Committee (MQuIC) is a partnership with the physical health organizations, the external quality review organization (EQRO), the Department and community to examine quality within existing and new systems of service and identify potential opportunities for improvement. MQuIC is scheduled to meet on the first Thursday of every other month from 1:30-3:30 pm and is held on the 4th floor at 1570 Grant Street, Denver, Colorado 80203.
The Medical Services Board sets forth the rules that govern the Department's programs. The Board was established by law effective July 1, 1994 and consists of eleven members appointed by the Governor and confirmed by the Senate. Medical Services Board meetings are open to the public.
The purpose of Nursing Facility Advisory Committee is to identify challenges in providing Medicaid services in nursing facilities. This committee provides an opportunity for Department staff, recipients, and providers to discuss issues unique to nursing facilities and their residents.
The Nursing Facility Provider Fee Advisory Board (PFAB) serves as a forum where the Department and stakeholder community can discuss the Nursing Facility Provider Fee program. The PFAB will explore alternative modeling options and approaches to improving and maintaining the program. The Board consists of community volunteer members who are familiar with the Nursing Facility Provider Fee program and reflect the diverse interests of the stakeholder community.
The function of the Board is to promote improved quality of life at nursing facilities through grants that support progressive culture change.
The Participant-Directed Programs Policy Collaborative (PDPPC) is a stakeholder/Department meeting that replaced the Consumer-Directed Attendant Support Services (CDASS) Advisory Committee in January 2012. The PDPPC is a place where CDASS stakeholders and the Department work together, with transparency, on CDASS issues going forward.
The Pharmacy and Therapeutics (P&T) Committee performs clinical reviews of drug classes and makes recommendations which help the Department develop and manage the Medicaid Preferred Drug List (PDL). The P&T Committee is required to consider clinical criteria such as drug safety and efficacy when making its recommendations and considers public comments and testimony related to the drug classes being reviewed or other PDL-related agenda items.
The Redesign Workgroup for Waivers Serving Adults with Intellectual and Developmental Disabilities (Waiver Redesign Workgroup) was formed by the Department in response to the Community Living Advisory Group's recommendation for a redesigned Home and Community-Based Services (HCBS) waiver to support eligible adults with intellectual and developmental disabilities.
The purpose of the School Health Services (SHS) Stakeholder Forum is to provide an informal environment for the SHS Program participating providers and other stakeholders to exchange ideas, review policies and other pertinent information that relates to the SHS Program. The group can make recommendations to the Department for improvement and changes to the SHS Program that address processes and services.
The purpose of this program is to promote the health and welfare of Colorado’s low-income seniors by providing access to dental care to individuals age 60 and over who are not eligible for dental services under any other dental health care program, such as Medicaid.
The Colorado State Medical Assistance and Services Advisory Council exists to improve and maintain the quality of the Medicaid Program by contributing specialized knowledge and experience and providing a two-way channel of communication with the individuals, organizations, and institutions in the community that provide medical care and services. State Medical Assistance and Services Advisory Council meetings are open to the public.