Colorado Department of Health Care Policy and Financing

The Medical Services Board meeting included discussions and final adoptions of revisions to the Medical Assistance Rule concerning enforcement remedies related to survey deficiencies, medical leave from nursing facilities, management of personal needs funds, updates to the Hospital Discounted Care Rule, updates to the Medical Assistance Act Rule concerning Healthcare Affordability and Sustainability Provider Fees, and updates to the Continuous Eligibility for Medical Assistance programs. The board also discussed revisions to the Medical Assistance Eligibility Rules concerning the return of Buy-in Monthly Premiums Collection, the Wellness Education Benefit, Psychiatric Residential Treatment Facility Reporting Requirements, and Qualified Residential Treatment Program Reporting Requirements. Additionally, there were open comments regarding the Department grievance process and issues with Private Duty Nursing.

The Medical Services Board meeting included discussions and emergency adoptions of revisions to the Medical Assistance Rule concerning provider enrollment, emergency medical transportation, non-emergent medical transportation, subacute care, and dental therapists. The board also discussed revisions to the Medical Assistance Rule and Child Health Plan Plus program rule updates, focusing on clarification language for members renewing after the Public Health Emergency. Initial approvals were granted for revisions to the Medical Assistance Act Rule concerning the Care and Case Management System and Adult Day Services Dementia Training.

The Medical Services Board convened to address several key issues. The board discussed revisions to the medical assistance act concerning base wage regarding certain Home community-based Services, an increase in the co-payment for non-emergent use of Emergency Department Services, and non-invasive prenatal testing. The board also reviewed a rule change for the Colorado Dental Health Care Program for low-income seniors and the old age pension Health Care Program. Additionally, the board discussed revisions to the medical assistance rules concerning Skilled Nursing Facility enhanced supplemental payments.

The meeting included a roll call and announcements, followed by a discussion on an emergency rule, MSB 241030-C, concerning vision services changes and early and periodic screening diagnostic and treatment or EPSDT alignment. The rule proposal involves a prescription limitation on aspheric lenses due to financial concerns and potential fraud. Stakeholder feedback was shared and adjustments were made to the proposed language. The board also discussed the removal of the prohibition on prior authorizations and the impact on the EPSDT rule.

The Medical Services Board meeting included discussions and actions on several key rules and revisions. The board approved revisions to the Medical Assistance Act concerning Durable Medical Equipment Billing Clarification, Out-of-State Hospital and Physician Services Rate Negotiation, and the Medicaid Buy-In Program for Children with Disabilities. Initial approvals were granted for revisions related to Managed Care Grievance Resolution Timeline, eConsults Specialist to Specialist, Cover All Coloradans Rule Clarifications, and Support Intensity Scale Assessment (SIS) and Interim Support Level Assessment (ISLA). The board also discussed the timeline for reporting, the burden on managed care entities, and the expedited grievance process. Stakeholder engagement and public testimony were part of the discussions, with commitments made to follow up on concerns raised. Rule previews were presented for Community First Choice, Children with Complex Health Needs Waiver, and Long Term Home Health.