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In an effort to continually ensure comparable access to medical services which is provided to non-Health First Colorado members, and in accordance with 42 CFR 447.203, Health First Colorado (Colorado's Medicaid Program) has developed an Access Monitoring Review Plan (the AMRP, or Plan) which outlines the processes used to monitor and act of access issues.
Learn more about the Access Monitoring Review Plan
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 Health First Colorado (Colorado's Medicaid Program). 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.
Learn More about the Accountable Care Collaborative (ACC): Medicare-Medicaid Program Stakeholder Meetings
The Department of Health Care Policy and Financing (Department) is committed to creating a high-performing, cost-effective system that delivers quality services and improves the health of Coloradans. The next iteration (Phase II) of the Accountable Care Collaborative (ACC) seeks to leverage the proven successes of Health First Colorado (Colorado's Medicaid Program) to enhance the member and provider experience.
Learn more about Accountable Care Collaborative Phase II
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.
Learn more about the Accountable Care Collaborative Program Improvement Advisory Committee
The purpose of the Advocates Communication Meeting is to ensure ongoing, transparent, and collaborative communication between the Division for Intellectual and Developmental Disabilities and the advocacy stakeholders.
Learn more about the Advocates' Communication Meeting
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.
Learn more about the Behavioral Health Quality Improvement Committee
Health First Colorado (Colorado's Medicaid Program) 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, members, advocates, policy makers, etc. into the process.
Learn more about the Benefits Collaborative
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.
Learn more about the Children's Disability Advisory Group
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.
Learn more about the Children's Services Steering Committee
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.
Learn more about the Colorado Choice Transitions Advisory Council
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.
Learn more about the Colorado Commission on Affordable Health Care
The Colorado Healthcare Affordability and Sustainability Enterprise 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 Health First Colorado (Colorado's Medicaid Program) and Child Health Plan Plus (CHP+) eligibility expansions are implemented as intended.
Learn more about the Colorado Healthcare Affordability and Sustainability Enterprise Board
The Colorado Hospital Transformation Program is an initiative under development by the Colorado Department of Health Care Policy and Financing (Department) in collaboration with the hospital community and other stakeholders in health care delivery.
Learn more about the Colorado Hospital Transformation Program
This Forum provides an informal environment for Colorado Indigent Care Program (CICP) member 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, member relations, and other pertinent issues.
Learn more about the Colorado Indigent Care Program Stakeholder Forum
The goal of the Colorado Opportunity Project (the Project) is to deliver proven interventions that create opportunities for all Coloradans to reach middle class by middle age.
Learn more about the Colorado Opportunity Project
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.
Learn more about the Community First Choice Development and Implementation Council
The Office of Community Living was created by Governor Hickenlooper through an Executive Order in July 2012. The Office helps meet the growing need for long-term services and supports by people with disabilities and aging adults and is housed in the Department of Health Care Policy and Financing (Department).
The Community Living Advisory Group worked from August 2012 to September 2014 to consider and recommend changes to the Long-term Services and Supports (LTSS) delivery system. The Advisory Group worked closely with the Colorado Commission on Aging and other planning groups to carry out this work and build on previous discussions and recommendations. The Advisory group finalized its work and issued its Final Report in September 2014.
Learn more about the Community Living Advisory Group
The Colorado Department of Health Care Policy & Financing (HCPF) houses an advisory committee focused on quality improvement for HCPF’s Office of Community Living (OCL). The Community Living Quality Improvement Committee (CLQIC) provides input to the OCL on the development of a robust quality strategy from a person-centered perspective.
Learn more about the Community Living Quality Improvement Committee
The Conflict Free Case Management Main Page exists to share information about Conflict Free Case Management regarding qualified individuals with Intellectual and/or Developmental Disabilities and their families. Conflict Free Case Management bars the delivery of Case Management Support and Home and Community Based Direct Services by the same agency or entity.
Learn more about Conflict Free Case Management
The Conflict Free Case Management Task Group was formed to develop recommendations for consideration by the Department regarding a process to establish a conflict-free case management model for persons enrolled in the Home and Community Based Services (HCBS) waiver for persons with a Developmental Disability, (HCBS-DD), the HCBS Supported Living Services (HCBS-SLS), waiver and the HCBS Children's Extensive Support (HCBS-CES) waiver.
Learn more about the Conflict Free Case Management Task Group
The Consumer Direction in the Home and Community Based Supported Living Services (HCBS-SLS) Waiver Task Group was formed to develop policy recommendations for the implementation of Consumer Directed Attendant Support Services (CDASS) in the HCBS-SLS Waiver.
Learn more about the Consumer Direction in the HCBS-SLS Waiver Task Group
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).
Learn more about The Drug Utilization Review Board
The eHealth Commission was created to provide advice and guidance to the Office of eHealth Innovation on advancing Health IT in Colorado.
The Department of Health Care Policy and Financing (HCPF) serves as the fiscal agent leveraging the state’s procurement, contracting, and accounting established processes to manage solicitations, contracts, and payments to vendors and organizations on behalf of the new eHealth Innovation Office.
Learn more about the eHealth Commission
The Elderly, Blind and Disabled Waiver Stakeholder Group is an opportunity for Department staff and adult waiver stakeholders to work together to improve the provision of services within the EBD Waiver.
Learn more about the Elderly, Blind and Disabled Waiver Stakeholder Group
Through the passage of the Medicare Access and CHIP Reauthorization Act of 2015, federal financing for the Children’s Health Insurance Program (CHIP) was extended through September 30, 2017. It is unclear whether or not Congress will consider extending federal financing beyond 2017.
Learn more about the Future of Child Health Plan Plus (CHP+)
The federal Centers for Medicare and Medicaid Services (CMS) issued a final rule effective March 2014 to ensure that the provision of Home and Community Based Services (HCBS) occurs in settings that meet certain criteria. States have until March 2019 to ensure that their HCBS settings are compliant with the final rule which ensures that HCBS participants have access to the benefits of community living, and that services are true alternatives to those provided in an institutional setting and are delivered in the most integrated setting possible.
Ways to be involved in the Final Settings Rule Implmentation Process
The Health First Colorado (Colorado's Medicaid Program) Provider Rate Review Advisory Committee was created to establish a process for the periodic review of provider rates under the Colorado Medical Assistance Act.
Learn more about Health First Colorado Provider Rate Review Advisory Committee
We host quarterly meetings in partnership with the Department Public Health and Environment to discuss regulatory compliance issues with providers.
Learn more about Home Care Information Exchange Meeting
Hospital Back-Up (HBU) is a Long-Term Services and Supports Health First Colorado program that supports qualified skilled nursing facilities in providing hospital level care to members who are ventilator dependent, have complex wounds, or have medically complex needs, as defined in rule 10 CCR 2505-10 8.470.1. The Hospital Back-Up Redesign Advisory Committee has been developed to build on improvement recommendations identified by the University of Colorado's research of the HBU program.
Learn more about Hospital Back Up Redesign Advisory Committee
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 Health First Colorado (Colorado's Medicaid Program) and Child Health Plan Plus (CHP+) eligibility expansions are implemented as intended.
Learn more about Hospital Provider Fee Oversight and Advisory Board
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.
Learn more about the Medical Clean Claims Task Force
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.
Learn more about The Medical Quality Improvement Committee (MQUIC)
The Medicaid Provider Rate Review Advisory Committee (MPRRAC) was enacted in June of 2015 (Senate Bill 15-228) and operates in accordance with the Colorado Medical Assistance Act, Section 25.5-4-401, C.R.S. (Colorado Revised Statutes).
Learn more about Medicaid Provider Rate Review Advisory Committee
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.
Learn more about the Medical Services Board
The Department has created a Member Experience (formerly Person- and Family-Centeredness) Advisory Council to help us integrate a person-and family-centered approach into Department business practices, policies and partnerships by engaging with Health First Colorado (Colorado's Medicaid Program) and Child Health Plan Plus (CHP+) members and family members/caretakers. There is an In-Person and a Virtual Advisory Council. Both serve as a way for members and their families/caretakers to work collaboratively with the Department to identify and implement person-centered practices, and create sustainable culture change in the Department.
Learn more about the Member Experience Advisory Councils
The purpose of Nursing Facility Advisory Committee is to identify challenges in providing Health First Colorado (Colorado's Medicaid Program) 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.
Learn more about the Nursing Facility Advisory Council
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.
Learn more about the Nursing Facility Provider Fee Advisory Board
The function of the Board is to promote improved quality of life at nursing facilities through grants that support progressive culture change.
Learn more about the Nursing Home Innovations Grant Board
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.
Learn more about the Participant Directed Programs Policy Collaborative
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.
Learn more about the Pharmacy and Therapeutics Committee
As part of the Department of Health Care Policy & Financing’s (Department) efforts to shift providers from volume to value, the Department is developing a structure to make differential fee-for-service payments to give providers greater flexibility, reward performance while maintaining transparency and accountability, and create alignment across the delivery system. Under the proposed model, providers can earn higher reimbursement (when designated as meeting specific criteria) as they implement and achieve more advanced criteria. Movement along this framework not only encourages higher organizational performance but also helps the Accountable Care Collaborative (ACC) achieve its respective programmatic goals.
Learn more about Primary Care Payment Reform
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.
Learn more about the School Health Services Stakeholder Forum
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 Health First Colorado (Colorado's Medicaid Program).
Learn more about the Senior Dental Advisory Committee
The purpose of the Spinal Cord Injury Advisory Committee is to advise the Department as it reviews elements of the Spinal Cord Injury waiver.
Learn more about the Spinal Cord Injury Advisory Committee
The Colorado State Medical Assistance and Services Advisory Council exists to improve and maintain the quality of Health First Colorado (Colorado's 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.
Learn more about the State Medical Assistance and Services Advisory Council
This page exists to provide and exchange information with members, stakeholders, providers, legislators, and policymakers about the Department's efforts to ensure qualified individuals recieve the services they need at the time they're needed, within the constraints of the state's limited financial resources.
Learn more about Waiting Lists and Enrollments
The Waiver Implementation Council provides advice and consultation for DIDD's efforts to redesign its home and community based services waivers serving adults with intellectual and developmental disabilities.
Learn more about the Waiver Implementation Council - DIDD
