Jump to navigation
The following are projects which are in the process of being implemented. Please refer to the appropriate topic for further information. If a project was listed here before, please refer to the Provider Resources web page for further information.
The Accountable Care Collaborative Program is Health First Colorado's primary health care delivery model. ACC Primary Care Medical Providers (PCMPs) are key to the success of the ACC. Learn more about the ACC.
New Federal Provider Screening Regulations
This month, Health Care Policy and Financing (the Department) made an emergency change to the provider screening rule to remove the March 31, 2016 deadline for providers to revalidate with Health First Colorado. The next step is to make the rule emergency rule permanent. The Department values the input of the community and our partners. To that end, comments about our emergency change and pending permanent change are welcome.
The changes are viewable in this document; please direct comments to ProviderScreeningComments@state.co.us
New federal regulations established by the Centers for Medicare and Medicaid Services (CMS) require enhanced screening and re-validation of providers enrolling with Health First Colorado. These regulations are designed to reduce the potential for fraud, waste, and abuse. The Department is seeking stakeholder feedback on how to implement these federal regulations.
Most providers will see very little change in their enrollment process but some may be required to undergo additional screening before they can be enrolled or re-enrolled in Health First Colorado. CMS has developed three levels of provider screening rigor based on the potential risk of waste, fraud and abuse. CMS has previously determined the particular risk level of most major provider types (e.g., physicians, clinics, hospitals, community mental health centers).
Provider Screening Rule - This link will direct you to the Colorado Secretary of State website. From there you will need to click on the link under "Current version"; the Provider Screening Regulation is section 8.125 and begins on page 135.
Provider Resources Page - The Department has created a dedicated web page for revalidation and screening instructions and FAQs.
Targeted Health First Colorado (Colorado's Medicaid Program) Rate Increases were approved by the General Assembly for the 2015-2016 fiscal year to mitigate rate inequities, improve access to care, and improve health outcomes. Approved Across-the-Board increases, if applicable, may also apply to provider rates. Below are links to the Fact Sheet and Frequently Asked Questions for both types of rate increases.